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SU0011163 SSNL
EnvironmentalHealth
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SU0011163 SSNL
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Entry Properties
Last modified
5/7/2020 11:34:59 AM
Creation date
9/4/2019 5:50:20 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SU0011163
PE
2625
FACILITY_NAME
PA-1600220
STREET_NUMBER
11751
Direction
W
STREET_NAME
EIGHT MILE
STREET_TYPE
RD
City
STOCKTON
Zip
95219-
APN
06908006
ENTERED_DATE
12/19/2016 12:00:00 AM
SITE_LOCATION
11751 W EIGHT MILE RD
RECEIVED_DATE
12/16/2016 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\E\EIGHT MILE\11751\PA-1600220\SU0011163\SS_NL STUDY .PDF
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EHD - Public
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ENVIRONMENTAL CHAIN OF CUSTODY <br /> ` dNDANAL YSlS REQUEST DOCUMENT <br /> Lab Number: TEST DESCRIPTION AND ANALYSES REQUESTED <br /> 1175)575 <br /> Clive: Live Oak GeoEnvironmental <br /> Cunec.er .Number. 3016608 <br /> A`a""' 407 W.Oak SL <br /> Lodi,CA 96240 <br /> wee (209)369-0375 Fax: <br /> EmailAdd,.: abby@IOgelodl.com s o <br /> Con=Person: Abby Racco 3 <br /> Pmjen Nmnt:Empire Island Duck Club, :9 0 T e <br /> Pvchaaeordcr Numbeo 11751 W. Eight Mile,Stockton £ =i <br /> Qeme N,unl'.. <br /> 6Z5 <br /> g f v z— <br /> P � F gd � h p <br /> SumPlinB Pec: __.. Pickup Fec: <br /> Cw,pnsiuc sump Dau:: Time: 2 <br /> Samp f I.eenien Ikuriplitm Dat. 'I'imc Z <br /> N= ;gS�amP $anyrl<tl <br /> 0 Travel Blank sD G 2 G X <br /> 1 Domestic Well 2141f!}. / ; SO G 3 PIG. P DW SRC_O _ 4 X X <br /> Remarks I R jWiw�i nae: Tine: ��Rur�qulish'dd Dan.- Time: Rcli ahed Dm<: rum: 4 <br /> rK <br /> R=ww By: DNe: Time: R ved By: e: Tlme: Raeir By: Dat : Time.! <br /> aLT�17 130 �oD �,� �,f 1 <br /> corporate offices&laboratory .._ Office&laboratory Office&Laboratory Fleld Office <br /> 853 corpom6on Scoot 25o0 stageoaech liaeo 563 E.Undo Avenue V."ie.Cardomia <br /> Santa Paola.0 93080 Stochlon.CA 95215 CNoo.Cws5926 TEL:5591734-9473 <br /> TEL:SOSW2-200D TEL 2091992-0182 TEL:530/3935518 Moblle:5591737-2399 <br /> FAX:8051525.4172 FAX:209/9x2-0923 FAX 5301343-3807 FAX:5b9934-8435 <br /> CA NELAP CeA fication No.01110CA CA ELAP Cedirtca8on No.1563 CA EIAP Cenlfoeon No.2670 <br />
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