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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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35500
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2900 - Site Mitigation Program
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PR0508043
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Last modified
5/27/2021 2:02:02 AM
Creation date
5/24/2021 4:13:15 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
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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CHAIN OF CUSTODY RECORD -- Bill To: he r-X1 ccLh <br /> Sherwood 8071 N. Lander Avenue <br /> P.O. Box 937 <br /> 411 Hilmar, California 95324 <br /> Labs (209) 667-5258 Atlention: <br /> c 0 R P 0 R A T , 0 N FAX (209) 667-2581 f 1 ')( L no Ph e: -&-1 I-5 s ' age of <br /> Job Number: P.O.k Prolecl Name <br /> n� <br /> -7 . ;1 <br /> 5 <br /> Samplers:(Signature) Site Address <br /> �Qv <br /> SAMPLE SAMPLE NO.. P <br /> NUMBER DATE TIME TYPE SAMPLE INFORMATION OF REMARKS <br /> CNTRS <br /> 30 C-13Sl. <br /> I -Zi-x 5 1 C•V??s ) <br /> f561-1 & - 6-5 C,0!� ) � <br /> 1 -5- <br /> JI J' 11[7' 1U•� C I "J DO <br /> COSO <br /> Rel'n uished By:(Signa DalelTme Received By:(Signature) Datefflme Ship vle: <br /> Ree�tinquis ed By:(Signature) Daa/tel7ime PR6.dc.1i4ed <br /> ev :(Signature) Daalo/n <br /> /�l,j/i��i TURNAROUND TIME: <br /> Retinq shed By:(Signature) Date�ma By Laboratory DalaMme ❑24-HR ❑48-HR5-DAY ❑ 10-DAY <br /> 1 1 ) 1 <br /> DISTRIBUTION:Original-Accompanies Shipment: Canary Copy-Sherwood Pink-Sampler NOTE:Samples are discarded 30 days after results are reported unless other arrangements are made. <br />
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