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FIELD DOCUMENTS
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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E
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88 (STATE ROUTE 88)
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13975
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2900 - Site Mitigation Program
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PR0522057
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FIELD DOCUMENTS
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Last modified
11/20/2024 9:23:26 AM
Creation date
9/5/2019 2:14:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0522057
PE
2950
FACILITY_ID
FA0015024
FACILITY_NAME
USA GASOLINE #3756
STREET_NUMBER
13975
Direction
E
STREET_NAME
STATE ROUTE 88
City
LOCKEFORD
Zip
95237
APN
01908014
CURRENT_STATUS
01
SITE_LOCATION
13975 E HWY 88
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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Billing Inf r ation: — Alpha Analytical, Inc. <br /> Name �a W ; s kA 255 Glendale Avenue,Suite 21 Page# of/ 9 8 <br /> Address l0_5 * V,f-, IU , Sparks,Nevada 89431-5778 <br /> City,State,zip Q Phone (775)355-1044 <br /> Phone Number Fax Fax (775)355-0406 Analyses Required <br /> Client Name <br /> A ( IV,) , ��r• P.O.# Job# <br /> Address (j I 5 J r VW PWS# DWR# J <br /> City,State,`zipp ` II Phone# Fax# <br /> Time Date Maw* office Use Sampledby u_� Report Attention Total and type of <br /> Sampled Sampled See Key Only �1 a G" containers <br /> Below Lab IDNumber Sample Description **Seebelow REMARKS <br /> tA v 31-Rao to (- 13,I I - <br /> )A <br /> 15:31 IJ-1, - <br /> P-3 I /'� v' ✓ h <br /> ;�,1) =�- I'L' ✓ .ice SRtm <br /> 11,5 �� 0 �- ► V, v- PI..'lvu✓l. <br /> ADDITIONAL INSTRUCTIONS: <br /> _,_.SignatVT Print Name Company Date Time <br /> Relinquished by <br /> Received by <br /> Relinquished by <br /> Received by <br /> Relinquished by <br /> Received by <br /> *Key: AQ-Aqueous SO-Soil WA-Waste OT-Other **: L-Liter V-Voa S-Soil Jar O-Orbo T-Tedlar B-Brass P-Plastic OT-Other <br /> NOTE: Samples are discarded 60 days after results are reported unless other arrangements are made. Hazardous samples will be returned to client or disposed of at client expense. The report for the analysis <br /> of the above samDles is aDDlicable onlv to those samnles rer"eived by tha lahnratnni with this nnr Tha linhility of fho lahnrn+n..,;, +„41— — { -aL_-_.-_.i <br />
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