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SITE INFORMATION AND CORRESPONDENCE
Environmental Health - Public
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2900 - Site Mitigation Program
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PR0508043
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
5/24/2021 7:04:54 PM
Creation date
5/24/2021 11:28:39 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0508043
PE
2960
FACILITY_ID
FA0007905
FACILITY_NAME
CHEVRON PIPELINES
STREET_NUMBER
35500
STREET_NAME
WELTY
STREET_TYPE
RD
City
VERNALIS
Zip
95385
APN
25526003
CURRENT_STATUS
01
SITE_LOCATION
35500 WELTY RD
P_LOCATION
99
QC Status
Approved
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SJGOV\dsedra
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EHD - Public
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Geological Technics Inc. L. <br /> 2601!burr 9(pad <br /> M.4,w,California 95351 <br /> (209)538.642414 wC# 538.5852 <br /> Praject+#� Client/Project Name �S a Laboratory Name& Address <br /> Site Address j�i—OD <br /> Sampled by: (signature , G a R ❑ �� �p�3 1 <br /> 4 f• r <br /> Date Sample I.D. Z Remarks: <br /> sI Ice. <br /> r3 i S— 3z,�� <br /> -Lz, c;:� <br /> 31 S 3z .o <br /> R 's a ig ] r�Date/Time ive by: (signa I PLEASE RETURN SAMPLE CONTAINERS Remarks: <br /> �2, , —S&,TP <br /> Rekinquis ed by: (signature ate/Time ved by: (sin ) CC: <br /> Relinquished by. (s' azure) Date/Time Received by: (sigI)ature) <br />
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