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COMPLIANCE INFO_2021
Environmental Health - Public
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EHD Program Facility Records by Street Name
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W
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2300 - Underground Storage Tank Program
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PR0232482
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
11/24/2021 3:07:00 PM
Creation date
8/23/2021 11:27:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0232482
PE
2361
FACILITY_ID
FA0003719
FACILITY_NAME
WEST LANE CHEVRON
STREET_NUMBER
4747
STREET_NAME
WEST
STREET_TYPE
LN
City
STOCKTON
Zip
95210
APN
10437010
CURRENT_STATUS
01
SITE_LOCATION
4747 WEST LN
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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Laboratories Inc. 0; <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 2128889 Page 2 of 2 <br /> BC LABORATORIES INC. CODLJ---F;RECEIPT FORMP e�Of <br /> submnlsslon <br /> SHIPPING INFORMATION SHIPP MG CONTAINER FREE ]QUID <br /> Fed Ex ❑ UPS❑ CSO Z GLS❑ 13ancr Oslivery ❑ Icq ch-tg None !0 Box ❑ G <br /> 13C Lab Held Servrca Other❑ft8Gif-y)ti Other (3pocitv)� <br /> R #rigarant= rc vrueioea None-0 OI#ter❑ Comments: <br /> Custody!S;..IE .!c Chist Q icontakiers❑. None Comrnwitt: <br /> Inleck7Yae0 ild�O Ima[t?Yas ❑-rio ❑ <br /> Arl samples metiynd7 Y No❑ All Samples canlareere Indset? Yes No G QeaoKpliwa(s)malch COC? Yrs ko ❑ <br /> COC Reineived En7lssiv:ky: _ Cor+talnew ;heTmameter'ID: !}BLeITro <br /> ZEA <br /> / ONO Templ?naure' (A) (C } -c a�at klea <br /> S,4 FILF NUMBEPR <br /> -SAMPLE COrJS'Wrar;RS <br /> PE 17N3'RYS <br /> 4axt3axf[dsx PFg7rryRE3 <br /> 2 � <br /> T JMOF[[' Jit,Af$T,LLS <br /> 3ND RCA NEC CHF.hi Ur.?30Z?J dee <br /> PT LYARLim <br /> PY JVIYAUGPT+I l X]p]!4 <br /> FT TOTAL& D <br /> 2o-i34LM T r TE: <br /> YTTOaT QFqMCCARIION <br /> prCn GEN URMAND <br /> F!A PAFAprx <br /> -OMr VQA k jLL TTtA <br /> aaai vo v 4 <br /> EPA!d <br /> PT caoox <br /> lIAb kLMCIgAL <br /> 8AL-TFR GICAL <br /> 49 mlv v]AL•10s <br /> &Ph SU&'bU9�tD33J <br /> QTFSAjISAA3flA <br /> P <br /> Di EPA 125.1 TJtAvrr.BLAW <br /> 4 m <br /> QT <br /> r♦D�h]F <br /> Roe iFA`�8,! <br /> 8EA SdA.S <br /> E 303 <br /> OTETABIVIC <br /> 1 i,fa¢1]J7ox e <br /> 134a"S2nx <br /> &OCLJsLEEVT. <br /> FCB VIAL <br /> pLAsTrc BAG <br /> TJBULAa 7JAC <br /> 17'EWLflLl6lR{}Ft <br /> KbicfniE <br /> sMAkr FoT <br /> SUMMA CANJrMR <br /> rr3nrenle; <br /> sample Namhrrjng Cornpreked 2Y. <br /> 1 C Pa1a+TYn6: Poev?3 wlnavir <br /> 4=4tkua] =Loeretk4d Is:iwao�reorePM,enablsuaae �s�veeewrttl <br /> The results in this report apply to the samples analyzed in accordance with the chain of custody document.This analytical report must be reproduced in its entirety. <br /> All results listed in this report we for the exclusive use of the submitting party. BC Laboratories,Inc.assumes no responsibility for report alteration,separation,detachment or third party interpretation. <br /> Report ID: 1001220098 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.belabs.com Page 4 of 51 <br />
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