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ARCHIVED REPORTS_XR0007343 CASE 2
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0540424
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ARCHIVED REPORTS_XR0007343 CASE 2
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Entry Properties
Last modified
6/11/2020 12:33:08 PM
Creation date
6/11/2020 12:04:32 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007343 CASE 2
RECORD_ID
PR0540424
PE
2960
FACILITY_ID
FA0023098
FACILITY_NAME
RMC PACIFIC MATERIALS - T0607700371
STREET_NUMBER
30350
Direction
S
STREET_NAME
TRACY
City
TRACY
Zip
95377
CURRENT_STATUS
01
SITE_LOCATION
30350 S TRACY
QC Status
Approved
Scanner
LSauers
Tags
EHD - Public
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STL San Francisc hain of Custody <br /> 03='*TL 1220 Quarry Lane • Pwanton CA 94566-4756 Reference# <br /> hone 925 484-1919 • Fax 2 <br /> { } (9 5) 484-1096 <br /> �r .'f Email rnfo(c�chromalab com Date / -Z,0-3 <br /> Page of <br /> Report149MtAnalysisRequest <br /> Attn O8�"' �1bEiJXEGysEi✓ <br /> 0 <br /> X t o�m Q LL <br /> Company PiQ�/f/C Tf a m m n o E 2 U ° <br /> p�fA}'4' �� o � C1m w ❑❑ m E� mcn 00 <br /> Address P� oX 5.2 S2 / ❑❑ � c o o vy o� ao aMo � a o ¢F z❑ <br /> g J C7 c7 m y y o 0 0 [� 4 E q ❑ <br /> Phone .tfJ�24/Email X 8 fl fl O ❑o n 0`° a i- m ao o n i` ❑❑ ti p <br /> LU Q¢ v <br /> Bill To Sam I ~ EW M �❑ om �❑ U ❑❑ CL ❑ o a <br /> ❑ w ao a c ❑ - <br /> P Y °O o❑ oma Q �a mo 0C3 �� ❑❑ D m� m N m� ° Um` o <br /> �¢ ¢D a yua rnN mN mQ m ya �a 'mN ©❑ c) <br /> ¢- a a- x Om Cd 0(o v �r ❑ w-+ X (V o <br /> LU W a)Attn Phone w m �X X 9i °'� mU oa �� w N "� �iF�- x n ViF� h �J <br /> � �XPw nw mQ � �p o <br /> Sample ■ Pres rix erv. aHsa am UT C� � v)❑ Oa <br /> Uw 213 ❑❑ ❑❑ ❑0 ¢ z <br /> GJ5 .1 7 >a°O Gw N <br /> f� Z <br /> 1215. N14 z <br /> � z <br /> i <br /> —V— <br /> Project Info. Sample Receipt Re i cashed 7 2)Relinquished by 3)Relinquished by <br /> Protect Name #of Containers <br /> Si nature Time T Signature Time Signature Time <br /> Protect# Head Space 11-1,7-o-3 <br /> Yo 9zrp, '4,ebE�Nu N <br /> PO# Temp Printed Name Date Printed Name Date Printed Name Date <br /> Ffle <br /> Credit Card# /�C<f/C � <br /> Conforms to record Company Company Company <br /> T 1)Received by 2)Received by 3)ReceivI by <br /> A Day 72h 48h 24h Other �� 3 <br /> T <br /> Repo'fr D Routine D Level 3 ❑Level 4 ❑EDD D State Tank Fund EDF Signature Time Signature Time Sigatur Time <br /> Special Instructions/Comments D Global ID n �� <br /> Printed Name Date Printed Name Date Printed Name 1` Bate ' <br /> Company Company Company <br /> Rev 07102 <br />
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