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ARCHIVED REPORTS_XR0011768
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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F
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F
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5491
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3500 - Local Oversight Program
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PR0545028
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ARCHIVED REPORTS_XR0011768
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Entry Properties
Last modified
12/6/2019 5:01:47 PM
Creation date
12/6/2019 3:06:39 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0011768
RECORD_ID
PR0545028
PE
3528
FACILITY_ID
FA0003919
FACILITY_NAME
VAN DE POL ENTERPRISES
STREET_NUMBER
5491
STREET_NAME
F
STREET_TYPE
ST
City
BANTA
Zip
95304
CURRENT_STATUS
02
SITE_LOCATION
5491 F ST
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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fCC7 <br /> 1{'ia)1�1tA'1`EI) iNSUltANCi�P.O. Box 586, Citrus Heights, CA 95611 <br /> PNIC <br /> C11AIN OF CUSTODY <br /> INf ASS URFRC[ Of UU+IIIIT L1 Novato, CA, I I Digital Drivc, 9.1939 <br /> 1111Th;: (415) 883-6100 Fax: (415) 883-2673 <br /> Consultant's Nanle: Aegis Environmental, Inc. lrc& Moore Petroletlln, In Page of <br /> Address: 1050 Melody Lane, Suite 160, Roseville, California 95678 Federaled Sile Location. 5491 t Street, <br /> Project Contact: Laura Odenthal mwne #: (916)782-2110 Fax p: (916)786-78301 Fede raved Coni act: <br /> Sant ded h ()rint): +•. Sant filer's Si 'nature: _ Phunc y: _ FAx a: _ <br /> 2121 <br /> Shipment Method: Consull:wt Project if: 90-099 Federated Claim ar: 837-162 <br /> TAT: ❑ 24 hr ❑ 48 hr ❑ 72 hr Standard (10 day) Sample Condition as Received <br /> ANALYSIS RP_ tIIRFI) Temperaitfre' C; <br /> Cooler a: <br /> o <br /> I❑houttd Seal Yes No <br /> ca olllhnllnd Seal Yes No <br /> Cn Vl N h <br /> Ql^ <br /> Sample Description Collection htalrix Prsv N of PACE0� p� <br /> DaIC/NOW SniVWatel Cunt Sau114C# Mg x< <br /> n.a. 0.0. C'pA1h1LN'TS <br /> Mw rw <br /> E <br /> Relinquished by/Affiliation Date Time cce ted y/Affiliationle Time Additional Comments; <br /> MOP <br /> a �. y <br /> hZ5 <br /> Z (/!7 <br />
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