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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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.dvanced Geo Environmental, Inc. www.adv,gc;oenv.com CHAIN OF CUSTODY RECORb, <br /> 837 Shaw Road,Stockton,California 95215 • Phone(209)467-1006 • Fax(209)467-1 1 18 Date: I " Page Of f <br /> i� '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 11, Monterey,California 93940 • Phone(800)511-9300 • Fax(831)394-5979 <br /> Project Name Project Manager <br /> 1�'; . l <br /> Client 1 Sampler(initials&signature) <br /> i fn�i y G�fn .JAI}� <br /> Lab Project No.: <br /> Invoice to: AGE ❑ Client <br /> Sample ID/Location/Description Date Time Matrix Number Notes <br /> Relinquished by: ,- Date: Time: Laboratory: <br /> On <br /> Courier: Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: ^ r Date: Time: <br /> i <br /> Requested Turn Around"fime(circle): 24 hours 48 hours 72 h6urs 5 days(standard) Other:_-_ _ Matrix Codes: A=Air W=Water S=Solid <br /> Special Instructions to lab: 1 hereby authorize the performance of the above indicated work. <br /> .r <br /> Global ID: '1 <br /> Geotracker EDF to: ❑ geotracker@advgeoenv.com ❑ �r� <br />
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