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EnvironmentalHealth
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EHD Program Facility Records by Street Name
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ELEVENTH
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1755
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2900 - Site Mitigation Program
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PR0515574
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COMPLIANCE INFO
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Entry Properties
Last modified
11/19/2024 10:19:29 AM
Creation date
2/12/2020 10:50:23 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0515574
PE
2950
FACILITY_ID
FA0012225
FACILITY_NAME
POMBO PROPERTY (PRIME SHINE)
STREET_NUMBER
1755
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95376
APN
23217020
CURRENT_STATUS
01
SITE_LOCATION
1755 W ELEVENTH ST
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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Advanced GeoEnviron mental, Inc. www.advgeoerLv.com CHAIN OF CUSTODY RECORD, <br /> 01837 Shaw Road,Stockton,California 95215 • Phone(209)467-1006 • Fax(209)467-1 1 18 Date: _ I I Page__t__-of <br /> 381 Thor Place, Brea,California 92821 • Phone(714)529-0200• Fax(714)529-0203 <br /> :: :: ❑ 2318 Fourth Street,Santa Rosa,California 95404 • Phone(707)570-1418 • Fax(707)570-1461 Analysis Required <br /> ❑ 395 Del Monte Center,#111,Monterey,California 93940 • Phone(800)511-9300 • Fax(831)394-5979 <br /> Project Name , Project Manager <br /> Client Sampler(initials&signature), L/1 <br /> Lab Project No.: Q11— <br /> Invoice to: XGE ❑ Client <br /> f <br /> Sample ID/Location/Description Date Time Matrix Number Notes <br /> A44 a <br /> i/ <br /> )77 <br /> 05 <br /> V <br /> 1 U XX.- <br /> i 7555- <br /> Relinquished y: Date: Time: CC Laboratory: C 7L-7L <br /> —� <br /> Courier: Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: <br /> Date: 'rime: <br /> Requested Turn Around Time(circle): 24 hours 48 hours 72 hours 5 days(s ndard) Other: _.__ Matrix Codes: A Air W Water S=Solid <br /> Special Instructions to lab: I hereby authorize the performance of the above indicated work. <br /> Geotracker EDF to: ❑ gcotracker@,advgeoenv.com ❑ <br /> Global ID: <br />
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