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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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WELTY
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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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y� t <br /> CHAIN-OF-CUSTODY RECORD N° 0863 Date: Page Ti of <br /> Project No.: �24�e ANALYSES <br /> REMARKS <br /> Samplers(Signatures); 0 0 0 0 0 o eft c Additional Comments <br /> O O O N N C tiD Q .� <br /> r _ W o ►`Vrlolll�7[- w T�l-Id w i{-�, av,� <br /> m m m 0 m m f ii <br /> F <br /> a a a a a x x �7 8t7�i A ra T` Ica J e <br /> LOU' <br /> a Q� a a a d S o � s <br /> Date Time Sample Number w w w w w o ¢ y <br /> D u >b [St - t °l x x X W (o <br /> DL l li O A"-e. - w X X X X W Co.rbo,r, Raan�.t�6 <br /> _ TPt�9 — C� Ab c,Z <br /> e3 <br /> tvvica TF,-i i X WVA2 'Tr PA_.CIo-Lz�+ <br /> $27oc stl- <br /> PQ <br /> 9 <br /> Turnaround time: Results to: A t Totak No.of containers: ;�LLi ww ectn� <br /> Relinquished by(signature): Date: Relinquished by(signature): Date: Relinquished by(signature): Date: Method of Shipment: <br /> ULcc <br /> Laboratory Comments and Log No.: <br /> Printed N i e: Printed Name: Time: Printed Name: Time: <br /> L r 1830 <br /> Company: Company: Company: <br /> Received by(sig ature): Date: Received by(signature). Date: Received by(signature): Date: <br /> It_ti-91 <br /> Printed Name: Time: Printed Name: Time: Printed Name: Time: <br /> Company: Company: Company: <br /> O8CMATRIX <br /> Fonns(PF).012 (Revised 12195) <br />
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