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FIELD DOCUMENTS_FILE 2
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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GRANT LINE
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13170
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2900 - Site Mitigation Program
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PR0505432
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FIELD DOCUMENTS_FILE 2
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Entry Properties
Last modified
1/24/2020 2:57:17 PM
Creation date
1/24/2020 2:31:46 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
FileName_PostFix
FILE 2
RECORD_ID
PR0505432
PE
2960
FACILITY_ID
FA0006779
FACILITY_NAME
DIVIDEND PROPERTY
STREET_NUMBER
13170
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95376
CURRENT_STATUS
02
SITE_LOCATION
13170 W GRANT LINE RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\sballwahn
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EHD - Public
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SunStar Laboratories, Inc. Chain of Custody Record <br /> 3002 Dow Ave, Ste. 406 <br /> Tustin, CA 92780 <br /> 1-800-781-6777 <br /> Client: :. '.�, z,.�:,►, � ' sa�' r_ Date: �� .z;: ' � Page: i Of <br /> )i. <br /> a - <br /> Address: ttr� trs".. .. #t z. .. mm:t f�. Project Name: <br /> Phone: C=(4(r "�t:�� its. t : Fax: E_`?1i a� �_ ct_;.M r: � Collector: _R � : ) Client Project <br /> Project Manager: tr".` ,.1' (Ai <br /> i• <br /> 1 9 ,-� •: ...FE :_t`_` t-�`-- Batch#: Proposal#: <br /> N <br /> N <br /> N <br /> ro <br /> o C <br /> r5 al O O <br /> C <br /> 6 = T > OU <br /> O O O ca r to to _O O _y <br /> O O N N O 4 O O O <br /> Co cow <br /> W V CO W W W 0 N <br /> Sample Container ¢ ¢ ¢ a ¢ ¢ Q a ¢ ID <br /> Sample!D Date Sampled Time Type Type w W W w w w Ww Lu `6 0- Comments � <br /> S <br /> Relinquished by:(signature) Date 1 Time Received by:(signature) Date I Time Total#of containers Notes <br /> ;.)1 'Al 4•' :i .t s u F p._i.'" <br /> Chain of Custody seats YININA �. <br /> Relinquished by: (signature) Date/Time Received by.(signature) Date 1 Time Seals intact?YININA <br /> Received good condition/cold <br /> Relinquished by: (signature) Date 1 Time Received by: (signature) Date/Time }' {""t f L 1. <br /> Turnaround timer <br /> Sample disposal Inslrudi0n5: (Disposal fc�$2 00 each Return to client �_ Pickup ___ <br />
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