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FIELD DOCUMENTS
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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BROADWAY
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1919
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2900 - Site Mitigation Program
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PR0539716
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FIELD DOCUMENTS
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Entry Properties
Last modified
2/11/2019 4:22:59 PM
Creation date
2/11/2019 3:32:05 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0539716
PE
2950
FACILITY_ID
FA0022723
FACILITY_NAME
WALDO ROSE STORAGE
STREET_NUMBER
1919
Direction
N
STREET_NAME
BROADWAY
STREET_TYPE
AVE
City
STOCKTON
Zip
95205
APN
14315001
CURRENT_STATUS
01
SITE_LOCATION
1919 N BROADWAY AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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CHAIN OF CUSTODY RECORD <br /> ® McCampbell Analytical, Inc. TURN AROUND TIME: RUSH ❑ IDAY U 2DAY �) 3DAY g 5DAY'zt'EX <br /> O 1534 Willow Pass Rd. / Pittsburg, Ca. 94565-1701 <br /> O <br /> www.mccampbell.com / main@mccampbell.com GeoTracker EDF ❑ PDF ❑ EDD 1:j10 DAY <br /> EQu[S ❑ ❑ <br /> Telephone: (877) 252-9262 / Fax: (925) 252-9269 UST CLEAN UP FUND ID ;Claim# <br /> Report To:9�(mi Bill To: 1 Analysis Requested Helium Shroud SN# <br /> Other: <br /> Company: v Notes:Please Specify units if different than <br /> default:VOCs is reported in ug/m3,fixed <br /> E-Mail: <br /> rn = c gas is reported in uL/L.Leak check default <br /> o. <br /> Tele: ( S ) -koO Fax: ( ) 1 l¢- E O y e ,n d is IPA. <br /> Project#: Project Name: �a6kd z <br /> Project Location: M ci Q d <br /> H u Z a s g <br /> Sampler Signature: E UO O d N ° Y C L ; Matrix <br /> U W :E O a d u oti,, L Canister <br /> Collection ;; a y H „ <br /> E. e „ o .: t Pressure/Vacuum <br /> Field Sample ID Canister SN# Sampler Kit SN# ' evn " o U o C7 C7 E U <br /> (Location) y F 9 - = -0 -0 o Y 9 °o <br /> U o = w a v a v • � = �+ s Initial Final <br /> Date Time = L " " a °J '" ° ° a <br /> > a°o F JUizr� tLZ o iz S .� .: Qa' O v� � <br /> S _ ti ip is Q 36 01t� (o\ta.3 ' 3� —3Z.3 <br /> �� Lola' oil 3► -�+3 - -3c3 <br /> - s <br /> Relinquished By: Date: Time: Received By: <br /> Temp('C) : Work Order#: <br /> Condition: <br /> RclinquisDate: Time: e v B'. <br /> Custody Seals Intact?: Yes No None <br /> Shipped Via: I <br /> Relinquished By: Date: Time: Received By: i <br /> c <br /> 1 <br /> Page 18 of 19' <br />
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