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SR0085874_SSNL
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2600 - Land Use Program
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SR0085874_SSNL
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Entry Properties
Last modified
11/19/2024 10:19:58 AM
Creation date
10/12/2022 3:43:02 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SR0085874
PE
2602
FACILITY_ID
FA0007821
FACILITY_NAME
ARCO & AM/PM
STREET_NUMBER
7500
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95376
APN
25015018
ENTERED_DATE
10/5/2022 12:00:00 AM
SITE_LOCATION
7500 W ELEVENTH ST
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\tsok
Tags
EHD - Public
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.6� ENVIRONMENTAL <br />Date: Time:Rot <br />client: Live Oak GeoEnvironmental <br />C ustonter Number; 3016608 <br />407 W. Oak St. <br />Corporate Officoa $ Laboratory <br />Lodi, CA 96240 <br />853 Corporation Street <br />PKII- (209) 369-0375 rax: <br />Santa Paula. CA 930W <br />Email Addr« : abby@logelodi.com <br />TEL: 8051392.2000 <br />contact Person: Abby Raeea <br />FAX: 8051625.4172 <br />Pry*clNam: ArcoJAMPM, 7500 W. Eleventh St., Tracy <br />)r <br />Purchase Order Number: <br />(Mote Number: <br />a <br />c <br />sanipler(s}: p <br />GQi <br />Sampling Fee: __.. pickup Fee: <br />C'ampcnc{tar Setup Date Tose. <br />Samp <br />l.t>zation Description ? Date <br />Iirnc <br />Num <br />Sampled <br />Sarttpled <br />0 Travel Blank,`2 t tap <br />1 Fol.►ic- Well Qj2 /y�,..iE;i0 <br />...._.. <br />CHAIN OF CUSTODY <br />,INI3 AiVALYSIS RF-QUTF_.ST DOCU,iIENT <br />Lab Number: TEST DESCRIPTION AND ANALYSES REQUESTED <br />a g <br />i <br />o 3 i i <br />It <br />z M ? g t 3 <br />n`m $ rli a a �+ n { l <br />0. <br />i; ^a e a a <br />c3 3 2C E�, J i t <br />A { <br />Ssi ggTC iY{ �SgXt Z { <br />2 6. N iTi tli C0� Vt 'r ° I <br />C-'...4PJG4 .P._©W .... SRG O . ... X_ .._.r ..._._. _ <br />RCttlark5RFK <br />Date: Time:Rot <br />Koceiv 11y: Date: Time: RkN <br />�1'//,V.22 16.6. <br />Corporate Officoa $ Laboratory <br />Office & Laboratory <br />853 Corporation Street <br />2500 Stagecoach Road <br />Santa Paula. CA 930W <br />Stockton, CA 95215 <br />TEL: 8051392.2000 <br />TEL: 209/942-0182 <br />FAX: 8051625.4172 <br />FAX: 2091942.0423 <br />CA NELAP Cortiru:ation No, 01110CA <br />CA ELAP Certification No. 1563 <br />10 A <br />hed f� )ate:/Tirne: <br />L 1-706 <br />By., trate: Time. <br />gg 1-W <br />Offlco & Laboratory <br />563 E. Linde Avenue <br />Chico. CA 95926 <br />1 P 5301343-5818 <br />FAX: 5301343.3807 <br />CA ELAP Certification No. 2670 <br />Rclinqui,4W <br />(_('5 <br />Rccci%rd By: <br />Date: Time: <br />r <br />to: <br />Data: Timo: <br />Field Office <br />Visalia, California <br />TEL: 559/734-9473 <br />Mobile: 5591737-2399 <br />FAX: 5591734-8435 <br />
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