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ARCHIVED REPORTS_XR0005128
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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M
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MOFFAT
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3500 - Local Oversight Program
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PR0545566
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ARCHIVED REPORTS_XR0005128
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Entry Properties
Last modified
9/23/2020 11:13:16 PM
Creation date
3/17/2020 4:48:55 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005128
RECORD_ID
PR0545566
PE
3528
FACILITY_ID
FA0005479
FACILITY_NAME
MANTECA BEAN CO
STREET_NUMBER
229
STREET_NAME
MOFFAT
STREET_TYPE
BLVD
City
MANTECA
Zip
95336
CURRENT_STATUS
02
SITE_LOCATION
229 MOFFAT BLVD
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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4080 PIxE LANE, SUITE C AND ANALYSIS REQUEST 34507 <br /> jG-TEL CONCORD, CA 94520 <br /> 510 565-7852 1 <br /> �8001423-7143 ` ` <br /> lA °f Al° 111 OMC <br /> Company Name Phone# (j 1 o) 6 71 )-3 V 7 ❑ <br /> Gr ��u ° <br /> echn��� Z^< FAX# (oto) CYC~ 'i lin w ❑ _ ❑ <br /> Company Address Site Location a m ❑ ❑ <br /> ��IDS� Qdr� C�ic��. fj Inrlt�r G���3 C.r� ❑� ❑_ ❑ y ❑ <br /> CL <br /> CC <br /> Y) d ❑ i ❑ a <br /> Protect Manager Client Project ID (flyyj)< p 10� 6�Q� ❑ rn m a C <br /> ,` ((�� p m m = O n cc <br /> m <br /> 6r ti, U1-Sb C,I'o !21 r!1°+. rrar . � o a ❑ 0 ❑ ❑ z E ❑ E V ❑ ❑ <br /> a� ❑ ❑ ^ 6 c <br /> attest that the proper field sampling Sampler Name(Punt) a o " ° �, ❑ in <br /> z c C10 �❑ "o a N ❑ ❑ a a t © a w r o <br /> procedures were used during the r�,/�` fin` �` $ ❑ a <br /> Coll BCtlOn of these samples <br /> _ d m m ❑ w e o ❑ > o w ❑ LL <br /> Method <br /> Matrix Sampling m r N L h o p w w uai W ° ❑ ❑ <br /> Preserved <br /> Field GTEL ❑ d m ❑ ❑ ❑ a a ❑ `��. m <br /> Z ; U) I7 N m N N X r2 N C N <br /> Sample Lab IF a ws rLL; 0a a o Q b R o <br /> Lab Use z w J o o ua D o Q W =- F w w a i° a o a a <br /> ID 11 v N a N a o r = a W o o m m x o r w w w <br /> only o <br /> x — <br /> 07-- �d� S I Y P ' a x�� •'i`�sii `a'E '., <br /> I <br /> P-E <br /> F Y <br /> � <br /> SPECIAL DETECTION LIMITS REMARKS <br /> TAT Special Handling 1 <br /> Priority(24 hr) ❑ GTEL Contact <br /> Expedited(48 hr) ❑ Quote/Contract - <br /> 7 Bus+Hess Days ❑ Confirmation# Lab Use Only Lot# Storage Location <br /> other cL— SPECIAL REPORTING REQUIREMENTS <br /> Business Days )0 PO # <br /> QAIQC Level Work Order# C C, n ZeZ e <br /> Blue❑ CLP❑ Other❑— FAX❑ <br /> ! Date Time Received by <br /> CUSTODYRelinquished by Sampler ��r �, �- YL� <br /> /L Date Time Received by <br /> Relinquished by <br /> RECORD <br /> Date Time Received by Laboratory <br />
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