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COVWXIZZG (2)
Environmental Health - Public
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EHD Program Facility Records by Street Name
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ST ANDREWS
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2500 – Emergency Response Program
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COVWXIZZG (2)
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Entry Properties
Last modified
1/5/2022 11:42:36 AM
Creation date
1/5/2022 11:40:31 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
COVWXIZZG
PE
2546
STREET_NUMBER
3603
STREET_NAME
ST ANDREWS
STREET_TYPE
DR
City
STOCKTON
Zip
95219
APN
11821011
ENTERED_DATE
3/22/2021 12:00:00 AM
SITE_LOCATION
3603 ST ANDREWS DR
RECEIVED_DATE
3/22/2021 12:00:00 AM
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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SJGOV\ymoreno
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EHD - Public
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Received by: Relinquished by: Received by: Relinquished by: Received by: Relinquished by: \ .. <br />Uli 7 a) E <br />,.. , 11 Lab ID# ISampler Printed: ISampler Signature: IReport Attention: Alex Steele / Dave Larsen -0 <br />L3. <br />4t <br />-0 <br />0 <br />It I Phone / FAX: (209) 942-1401 I City/State/ZIP: Stockton, CA 95204 IAddress: 4040 West Lane Customer: PG&E Stockton \ <br />..1 ,----12--- -c- SAMPLE ID 6 <br />5 cr B) <br />0 <br />U) <br />a <br />g.). <br />f*P <br />- <br />oc <br />0 <br />r-il <br />Z <br />a, <br />8 D <br />g <br />m (P <br />---z <br />P <br />ki Printed Name 0 <br />9 <br />...--- DESCRIPTION/LOCATION SAMPLE TYPE <br />composite(c) discrete/grab(d) <br />\irl <br />L <br />-";.) — <br />i) <br />ID <br />6- <br />SAMPLE MATRIX <br />soil(s) liquid(I) vapor(v) other (o) <br />BTEX/MTBEJTPH-GAS 8021/8015 REQUESTED ANALYSES .-,i <br />Cc;. <br />‘P.2 <br />q <br />—I <br />3 CD <br />TPH-DIESEL - 8015 <br />TRPH 418.1M / SM5520C & F <br />C.J1' <br />..‹.,.., <br />-j- <br />F' <br />(1 Company Name Oxy's / EDB / DCA by 8260 <br />8260 -full list <br />\ \ <br />PCBs - 8082 <br />Electronic Deliverables (EDF) Turn Around Time: 24 Hour I I 48 Hour FI 3 Day 5 Day (Normal) I I Special: N .----- --- NUMBER OF CONTAINERS Total number of containers submitted to the laboratory OBSERVATIONS/REMARKS Notes: (2 03i-A Method of Shipment: CD <br />CD <br />CO <br />On <br />.D• <br />CD <br />5 <br />=: <br />ca. <br />CD <br />0) <br />CO <br />cT <br />0 <br />CD <br />cF) <br />CD <br />co cn co <br />CD <br />114 <br />m- <br />IS <br />9E£Z <br />Iuofle <br />gni <br />6 <br />06/90 <br />6 <br />6 <br />P19 <br />a) <br />0 <br />On <br />0 <br />ANOIV <br />NO <br />UV <br />I TV <br />DIL <br />LAI <br />VN <br />IV 1TLSVD <br />0 <br />0 <br />-1 0 <br /> <br />0 <br />
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