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2900 - Site Mitigation Program
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PR0009276
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Last modified
6/25/2019 8:43:45 AM
Creation date
6/25/2019 8:17:40 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0009276
PE
2960
FACILITY_ID
FA0012033
FACILITY_NAME
PILKINGTON NORTH AMERICA
STREET_NUMBER
500
Direction
E
STREET_NAME
LOUISE
STREET_TYPE
AVE
City
LATHROP
Zip
95330
APN
19812008
CURRENT_STATUS
01
SITE_LOCATION
500 E LOUISE AVE
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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CHAIN-OF-CUSTODY <br /> Condor earth Technologies, Inc. <br /> 21663 Brian Lane U/1 125 N.Golden State Blvd.,Ste.H Q Agro Environmental 1100 C Airport Blvd. <br /> N4 13 4 5 3 P.O.Box 3905 P.O.Box 3448 5651 N.Pershing Ave.,C-3 P.O.Box 30035 <br /> 4 Sonora,California 95370 Turlock,California 95381 Stockton,California 95207 Pensacola.Florida 32503 <br /> (209)532.0361 (209)668-9234 (209)474-1492 (904)•477.0454 <br /> f Fax(209)532.0773 Fax(209)668-9248 Fax(209)478.1716 Fax(904)477-0534 <br /> r67 - o <br /> SHIPPED TO: SEND RESULTS TO: <br /> NAME: <br /> .,S t C�Lcr�J l►i OFFICE: <br /> BILLING INSTRUCTIONS: <br /> ❑ PLEASE FAX RESULTS: LABORATORY REPORT NUMBER: <br /> PROJECT NO. _ NO ��o;• ���' �� tin' <br /> of <br /> SAMPLED BY: con- �� q3� ti"A? V� <br /> (Signature) <1 twin- �� 4q <br /> Date Time Samp ers O '� �7 REMARKS: 1.7ISC. <br /> � -3 A;G yi,*r--:5All <br /> J / <br /> 7— <br /> cpew <br /> r r41 vdML <br /> Pf 40 t r <br /> Lam' 1:! � •, <br /> Relinquished Date, Time, Received By: Date: Time: <br /> (signature) (Signature) `�[�t 3 ►� r <br /> Relinquished By: Date: 4Time: . Received By: Date: Time: <br /> (Signature) (Signature) <br /> Relinquished By: Date: Received By: Date: Time. <br /> (Signature) (Signature) <br /> ,t_c,, A Yellow-File Pink-Lop, Book GAROLI GRAPHICS(239(S27"3667 FORM J692, <br />
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