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ARCHIVED REPORTS_XR0012726
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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ARCHIVED REPORTS_XR0012726
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Entry Properties
Last modified
11/20/2024 9:21:19 AM
Creation date
9/5/2019 2:44:00 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012726
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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SJGOV\wng
Tags
EHD - Public
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CHAIN OF CUSTODY RECORD <br /> � RAs gnature). <br /> � r../.�, ��cl-�y,P r�r0,t� ApP/led Geo.Systems <br /> 4141-E Power fnn Road,Sacramento,CA 95x26 1916)452-ZSO1 <br /> Phone: -9 t' y5�2 Z -" •Fremont •Costa Mesa •5ac:2ment0 <br /> LABORATORY: SHIPPING INFORMATION: <br /> 41,1vLr 6-9 C EOS 5r6*.5 Shipper <br /> �3 Z 55� �r9°✓I� ���� _ Address <br /> _ /JZEr32rlrt( C�l�r' Date Shipped <br /> TURNAROUN13 TIME: . o? week-- Service Used <br /> Attention: Rt GUS Airbill No. Coo lot No. <br /> Phone No. ��� - _9D 1 <br /> Received by:(signatures) Date Tim® <br /> ui by:(signatures) 29�4m 'gyS <br /> 4 <br /> Received tol-lagora�b�� <br /> ® „y_3ORATORY SHOULD SIGN UPON RECSIP AND RETURN A COPY OF THIS FORM WITH THE <br /> LABORATORY RESULTS <br /> Date Analyses Sample Condition <br /> Sample <br /> Site Requested Upon Receipt <br /> No, identification Sampled <br /> W g-Mw1 2, 0- 27 P2 TYN 13Ei1� rct~7 c,� Cf <br /> y/- b? -_A w7_ 137 <br /> ,c370,1/0-Z a 'e 6� rcc'D w C' <br />
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