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ARCHIVED REPORTS_XR0005130
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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229
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3500 - Local Oversight Program
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PR0545566
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ARCHIVED REPORTS_XR0005130
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Entry Properties
Last modified
9/23/2020 11:17:13 PM
Creation date
3/17/2020 4:49:55 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005130
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 PIKE LANE, SUITE C C14A1N-OF-CUSTODY RECORD 3 6 6 7'5 <br /> GT E L CONCORD, CA 94520 AND ANALYSIS REQUEST <br /> I w r •o w r w r. (510) 685-7852 <br /> (800) 423-7143 <br /> Company Name Phone fl &10) 67) -.3 <br /> i <br /> rCG�1l1O �_rL FAX# U - rylye I I 1 1 <br /> it <br /> Company Address kiOS7 �-F chi try Site Location a,).q ym_,K-f /flu � m i I xi a of <br /> C�1 /)CG C� I I I I I I H Q <br /> A 4 s o ai a � a I I <br /> { )Oy�o201U2 3oJ IJ al � a ♦- <br /> Project Manager Client-Project ID # 2 + a I 1 a <br /> Ch N N N II <br /> W o a LI NI I I IT zl Z1 I I O c l l t i Cr <br /> !attest that the proper field sampling Sampler Name(Punt) a ISI o Q I I f I e a a 9 <br /> procedures were used during the C Z f' O N I-I a N of I t o N I I <br /> collection of these samples a � � y m a CD 430 l0 > 0 <br /> c U <br /> y Matrix MethodSampling 00 t7 a d l 1 W a a o l 1 1 i �, 1 1 a t 1 LL <br /> a Preserved m n � i t 1 1 w w ao a a m H w I I 0 11 <br /> Field GTEL z I ] y m $ N 3 47 <br /> Sample Lab# a w CrrS ;� R ¢ 0 a N co m w o y <br /> OE <br /> ID (Lab Use o w o 0 S o w F W w 9 D u 3 m a a a a a a <br /> 1 Only / v a p � ¢ iz U z N v iW a r T o a n. a s a a a a rJ a a — <br /> ar - Nan a 0 = = T - a o- <br /> < <br /> o H m m x x 0 ti au w w w w w w w w }- w U o c� <br /> -1 o 1IV 11 <br /> Iy -- <br /> �v-3 03 --- <br /> lu_ o4 — <br /> w-S 05 i - -- --- -- --- - - - <br /> TAT Special Handling SPECIAL DETECTION LIMITS REMARKS <br /> Pnonty(24 hr) 11 GTEL Contact <br /> Expedited(48 hr) 11 Quote/Contract N � ; <br /> 7 Business D ys It Confirmation N <br /> Otherr=w - SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot k Storage Location <br /> Business Days )0 P0 4 _ <br /> 0A10C Level <br /> Blue Cl CLP t I Other Ll FAX❑ Work Order b C6.03 0003 <br /> Relinquished by Sampler ^ �jt `J I 9-�'l <br /> CUSTORECORD Tam Received by <br /> DY Relinquished by Date Time Received by <br /> Relinquished by Date Time Received by Laboratory <br /> 3 �! !R5 :zl Waybill rl <br />
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