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ARCHIVED REPORTS_SITE STATUS REPORT 2011 THIRD QUARTER
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0009051
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ARCHIVED REPORTS_SITE STATUS REPORT 2011 THIRD QUARTER
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Entry Properties
Last modified
2/5/2020 3:21:20 PM
Creation date
2/4/2020 4:58:21 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
SITE STATUS REPORT 2011 THIRD QUARTER
RECORD_ID
PR0009051
PE
2960
FACILITY_ID
FA0000649
FACILITY_NAME
FORMER NESTLE USA INC FACILITY
STREET_NUMBER
230
STREET_NAME
INDUSTRIAL
STREET_TYPE
DR
City
RIPON
Zip
95366
APN
25938001
CURRENT_STATUS
01
SITE_LOCATION
230 INDUSTRIAL DR
P_LOCATION
05
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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TestAmericaa San Francisco � <br /> 1220 Quarry Lane PLP Lk7Z Test erica <br /> Chain of Custody Record THE LES U� � <br /> THE LEADER Sh EIVV€RONME:+ITAL TFSTSTEl4G <br /> Pleasanloji6 CA 94565 ( '] <br /> phone 925.484.1919 fax 925.500.3002 Tes9.America Lab ra ories,Inc. <br /> Cheat Comtaet Project Manager: Dinayak Aeharya Site Contact.Chris McCormack Date. 7i COC Xlo: <br /> Emrtronmental Cost Management Inc.(ECM) TdWas: (661)255-1693 Lab Contact.llimple Sharma Carrier. ECM of ME <br /> 3526 Hyland Ave Strife 200 Andysis Tarnamand Time Job No. <br /> Costa Mess,GA 92626 Cakndar(C)or ltloik Da <br /> (7 14)6622759 Phone TAT ifdiffereat fiom Betow El(734)662-2768 FAX 2 tseeks SDG No. <br /> Project name: Nestle I week <br /> Site: Ripon,GA © 2 days `:m N <br /> PO# 177 1 <br /> U <br /> sample Hot <br /> Sample Identification Sample Date Time Pres. lslatrix Coat Sample SpecificNotes: ❑ <br /> MW-3 "I �1 �i f31=13 HC1 H2O 3 x ❑ <br /> MW-7 0` '.5 IdOATE 1420 3, x <br /> MW-10 J, HC1 H2O 3 , x <br /> MW-18 1111)11 (�`) ` � HC1 H2O 3• x <br /> TB- O 1 �[! �t7 t t HC1 x20 2° x <br /> Preservation Used., 1-lee, 2=HCI; 3-WSO4; 4=RN03; S=NaOH;6=Other <br /> PossibFe.T=,,,dldenhfication — �t Sample Disposal(A fee may be assessedriif samples are retainelongerthan 4 month) <br /> C� �'or:-Hazard © Flmtn�rable 0 Skin Irritant Poi.'.J;3 Unknoiv#T""° ©Return Fo Client 150 Disposal By Lab ©Archive For Months <br /> Special Instructions/QC Requirements&Comments: REPORT DATA IN EMs FORMAT GLOBAL II)SL2050I2989 <br /> Rclinquisbad by: inpar*,:Environmental Bate.1Time: 7-&,7 - } eceioed by: Company:Tcst America Date?Time: <br /> Cost ManagemenkInc_ #3 Z.- <br /> Relinquished by: Company: UawTime: Received by Company, DateIT=: <br /> Rclinquishedby- imp Y: Ba1elTime Reeeivedby., Company: Datefl'sne: <br /> Page 32 of 35 08/05/2011 <br />
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