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ARCHIVED REPORTS_XR0006772
Environmental Health - Public
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EHD Program Facility Records by Street Name
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Y
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YOSEMITE
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853
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2900 - Site Mitigation Program
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PR0508124
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ARCHIVED REPORTS_XR0006772
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Last modified
7/27/2020 3:16:02 PM
Creation date
7/27/2020 2:21:53 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006772
RECORD_ID
PR0508124
PE
2950
FACILITY_ID
FA0007949
FACILITY_NAME
7 ELEVEN #21756
STREET_NUMBER
853
Direction
E
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
APN
22332015
CURRENT_STATUS
01
SITE_LOCATION
853 E YOSEMITE AVE
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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0 Chain of Custody Number <br /> SECOR Chain-of CuS#ody Record 3 & � ? L <br /> Field Office 077 Sacramento E3 Additional documents are attached, and are !part of this Record <br /> Address 3017 11011gom Road Surto 100 Job Name 7-Eleven Store#21756 <br /> Rancho Cordova CA Location 853 East Yosemite Avenue <br /> Manteca, CA <br /> Project# 77EL.21756 03 Task# 0410 Analysis R nest <br /> Project Manager Jaff Auchterlonie <br /> Laboratory Kiff Analytical I I z a <br /> Turnaround Time Standard 4 OR m <br /> ,U o $ o <br /> Sampler's Name Tom S 4 E CD <br /> _ <br /> eq 011 0 <br /> Sampler`s Signat a 15,F <br /> o <br /> 8° , si a Comments/ <br /> Sample ID Date Time Matrix HCI f`- m a i g m 0 . Instructions z <br /> MW-1 1-1-3-0,v Q30 Wager x X X1 3 <br /> MW-2 °Y yr Water x X X 3 °z <br /> MWS -/j'°Y oa Water x X X 3 03 <br /> MW-4 /'/s'4Y /o/ Water x X X 3 G`l <br /> Special Instructions/Comments Relinquished bp �"� Received by Sample Recei t <br /> 5 Oxygenates.TAME, MtBE, EtBE,TBA,DIPE Sign � Sign total no of containers <br /> Global ID#TO607700549(SIRC) Print Pratt Chain of custody seals <br /> email EDF to dacatlln@secor com Company Company Recd in good condition/oold <br /> email lab report to dherzog@secor com Time —DatE TE Date Conforms to record <br /> Relinquished by Received b7 <br /> Sign Sign Client SECOR <br /> Pnnt Print f o?X v r/ keacu,'2 Client Contact Bnan Carey <br /> Company Company , F Client Phone (916)861-0400 <br /> Tim Date Time /&zj- DateO//l o cl ext.241 <br /> Date /-/S-ay T Page , <br />
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