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2900 - Site Mitigation Program
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PR0009056
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Entry Properties
Last modified
10/3/2019 9:08:07 AM
Creation date
10/3/2019 8:44:44 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
WORK PLANS
RECORD_ID
PR0009056
PE
2960
FACILITY_ID
FA0004059
FACILITY_NAME
LODI DOOR & METAL CO
STREET_NUMBER
1220
STREET_NAME
VICTOR
STREET_TYPE
RD
City
LODI
Zip
95240
CURRENT_STATUS
02
SITE_LOCATION
1220 VICTOR RD
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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CHAIN OF CUSTODY: RAORD <br /> ' <br /> SAMPLERS:fB atu• )r, `.'a, i3 . .it•.. l r r �': /riu r3i 'C`' <br /> i }SHIPPING INFORM 710 <br /> Phone: 6750LK <br /> ?° "� ' 1 <br /> SHIPTO: MM Shipper Jr ti�r tc �f$�t <br /> Address <br /> �1�7 l�. Y11eFel /7✓i Ll41c- t'9 Date Shipped <br /> �R'S H o, C•4 1371/ Shipment Service -11141 41 <br /> yy�� <br /> p Airbill No. <br /> ATTENTION: Day-f QuG(4Y1e h Cooler No. <br /> Phone No. <br /> R 'nq�ur%shed I ignaure) Received by: (signature) Date/Time <br /> li quisheci by: (sign re) Received by: (signature) Date/Time <br /> Relinquished y: (Signature) Received by: (signature) Date/Time <br /> Relinquished y: (signature) Receiv f r la tory by':(Signature) D to/Time <br /> 'Analysis laboratory should complete, "sample condition upon receip , section below, sign and return top copy to <br /> J. H. KLEINFELDER & ASSOCIATES, 1975 "E" Street, Fresno, California 93706. <br /> Sample Site Date Analysis Sample Condition <br /> Number Identification Sampled Requested Upon Receipt <br /> 32ya W-7601-1 f2- I� HS Loo( <br /> it601 <br /> 3�2 tr :4 (9p I <br /> 32'-13 v bo L <br /> 3�.�I tr tf 1.0 �i <br /> 3� �}S it (o07i <br /> 4 ykq` QHS <br /> 3 y(41 MAI 15111.4 n-�alfS <br /> 3 3Z B rr 11tt�o✓THIS- �G�-lD�. ,�s�e,.D' <br /> - <br /> 32,5 <br /> bo 1 <br /> 3 <br /> 255, 600 Zi <br /> 3-256 r 4 '(NAAZIl.T o 'e <br /> 3�h2 fir V 60! <br /> 3 ?-G •� ii Leo?/ <br /> LM INSTRUCTIONS: Laboratory reports should reference and be billed by site IDN and contain the following: <br /> (1) summary of analytical methodology and QA work (blanks, spikes, duplicates) <br /> (2) dates for (a) sampling (b) lab receipt, (c) extraction, (d) injection/analysis <br /> (3) detectionlimits for all constituents analyzed for and reporting of all constituents detected which were not <br /> (4) specifically designated <br /> (5) `.Y� Cat/I-f d114 !hs lN4J <br /> ACS£ o <br /> White - Sampler Canary - J. N. Kleinfelder L Associates Pink - Lab Courtesy Copy <br />
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