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ARCHIVED REPORTS XR0006515
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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P
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PACIFIC
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6425
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2900 - Site Mitigation Program
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PR0519189
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ARCHIVED REPORTS XR0006515
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Entry Properties
Last modified
8/21/2019 5:20:05 PM
Creation date
8/21/2019 3:04:01 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006515
RECORD_ID
PR0519189
PE
2950
FACILITY_ID
FA0014347
FACILITY_NAME
CURRENTLY VACANT
STREET_NUMBER
6425
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
09741031
CURRENT_STATUS
02
SITE_LOCATION
6425 PACIFIC AVE
P_LOCATION
01
QC Status
Approved
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EHD - Public
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Aeportuig Inform <br /> �• CGent. KLAND P OPERTIES t�11It'!'lCQlt E111J11'011111Ci21�r Work, ,L1E1 r Pago_ <br /> Address <br /> 3444 Vincent Road,Pleasant Hill,, 1TEOUEST FOR ANALYSIS/CHA, .JF CUSTODY <br /> t 25853 -4648 Phone(510)930-9090 <br /> Contac FAX(510)930-0256 Lab Job Number <br /> Lab Destination <br /> Alt.Contact ___-- 64i, <br /> DA Samples Shipped <br /> Address Report To Send Invoico To Lab Contact <br /> Date Results Required <br /> 2• W1r5TERN G80—tNrfIEER.i 3• _ SAME AS #1 __ Dale Report Required <br /> 1186 t;- REAMERT9 _RFEl' _ Client Phone No - <br /> wnnnL.pNn , ( A4'776- 6 0 n I _ Client FAX No <br /> 5 <br /> ANALYSIS <br /> Send Reporl To i or 2 (Circle gne) <br /> Client P 0 No- Client Project t D No <br /> Sample Team Member(s) <br /> t r \y <br /> Lab Client Sampid- Air Date/ No d Type <br /> Number Idenbricatlor� Volume Time Type' Pres of of •�� ry <br /> /1 Collected ConL Cont Q Comments/Hazards <br /> �c-.7[ii.tst f ,C <br /> a <br /> Relinquished by / E(y TIME Rocehrod by DAT TIME <br /> (Sgneture) yam. l U (Signature) <br /> Relinquished by' DATE TIME Received by DATE TIME f <br /> (Signature) (Signature) 1 <br /> Retinqutshed by DATE TIME Received by DATE TIME <br /> (Sgnature) (Signature) <br /> Method of Shipment Lab Comments <br /> 'Sample type(Specify) 1)37mm 0 8 pm MCEF 2)25mm 0 8 pm MCEF 3)25mm 0 4 pm polycarb filter <br /> 4)PVC filter, diam pore size 5)Charcoal tubo G)Silica get tube 7)Water 8)Soil 9)Bulk Sample <br /> 10)Other 11)Other <br /> COPIES WttiTE JOBF&E YELLOW PMACT FILE PINK CLIENT <br />
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