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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
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EHD - Public
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Advanced GeoEnvironmental, Inc. www.advgeoenv.com CHAIN OF CUSTODY RECORD, <br /> 837 Shaw Road,Stockton,California 95215 • Phone(209)467-1006 • Fax(209)467-1118 <br /> Date: 1` 3, 1 k Page 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,#1 1 1,Monterey,California 93940 • Phone(800)511-9300 • Fax(831)394-5979 <br /> ❑ r <br /> Project Name Project Manager n 11 G <br /> Client Sampler(initials&si ature) - <br /> cv- ? <br /> Invoice to: .4GE ❑ Client Lab Project No.: <br /> Sample ID/Location/Description Date Time Matrix Number Notes <br /> (2,7 105 <br /> Relinquished by: Datc: Time: Laboratory: <br /> Courier: Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: J Date: Time: <br /> Requested Turn Around Time(circle): 24 hours 48 hours 72 hours 5 days( tandard) Other: _ _ Matrix Codes: A=Air W=Water S=Solid <br /> Special Instructions to lab: V I hereby authorize the performance of the above indicated work. <br /> Geouacker EDF to: 0 geotracker@,)advgeoenv.com ❑ Global ID: i <br />
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