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COUGKWFWJ (2)
Environmental Health - Public
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2500 – Emergency Response Program
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COUGKWFWJ (2)
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Entry Properties
Last modified
3/23/2022 4:02:41 PM
Creation date
3/23/2022 3:53:47 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
COUGKWFWJ
PE
2546
STREET_NUMBER
5839
Direction
E
STREET_NAME
ARMSTRONG
STREET_TYPE
RD
City
LODI
Zip
95240
APN
06107025
ENTERED_DATE
7/6/2020 12:00:00 AM
SITE_LOCATION
5839 E ARMSTRONG RD
RECEIVED_DATE
7/6/2020 12:00:00 AM
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
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SAiJQ Gi4nLis rccz 606/206 6P19 ANO.MIOUVI TVOLLATVNIV TIISVO 0217Z ON eTeo!4-109 -o <br />0 Acioisno JO NIVH0 11Received by: liRelinquished by: 1lReceived by: 11Relinquished by: IIReceiyed by: 11Relinquished by: A / Signature a_ <br />r—la) <br />W I Sampler Printed: 0-F\t-2tL-i--- (41\0S Sampler Signature: /../9...1 IIReport Attention: Alex Sleele / p6ye,Varsen )C--"407ti-1_ V\A :01 BO/ #t3 / #(0-Id I I Phone / FAX: (209) 942-1401 I[City/State/ZIP: Stockton, CA 95204 IlAddress: 4040 West Lane Customer: PG&E Stockton CXJ -- SAMPLE ID ---• <br />(1) <br />N.) <br />C"‘_.) <br />,....D <br />0-) <br />r ,i) <br />k•-, DATE ---- CT\ <br />1344. <br />— 0 R . <br />t.c\ ) <br />(7, <br />0, <br />cr, <br />r...., Printed Name G <br />r) <br />00 <br />c <br />ri DESCRIPTION/LOCATION SAMPLE TYPE <br />composite(c) discrete/grab(d) <br />i. \ L....) <br />• <br />0 <br />C) <br />0) <br />(1) <br />SAMPLE MATRIX <br />soil(s) liquid(I) vapor(v) other (o) <br />BTEX/MTBE/TPH-GAS 8021/8015 REQUESTED ANALYSES <br />N• <br />.-- <br />fil H — TPH-DIESEL - 8015 <br />TRPH 418.1M / SM5520C 8. F <br />all' <br />'.... <br />11 Company Name I <br />Oxy's / EDB / DCA by 8260 <br />8260 - full list <br />\ -N PCBs - 8082 <br />Electronic Deliverables (EDF) Turn Around Time: 24 Hour I I 48 Hour 3 Day 5 Day (Normal) [ Special: Z c\--i VM1a ........o. NUMBER OF CONTAINERS Total number of containers _ submitted to the laboratory OBSERVATIONS/REMARKS I Notes )krZ VOS Method of Shipment:
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