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EHD Program Facility Records by Street Name
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T
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12 (STATE ROUTE 12)
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20913
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2900 - Site Mitigation Program
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PR0545720
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Entry Properties
Last modified
11/19/2024 3:48:22 PM
Creation date
6/12/2020 11:34:45 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
WORK PLANS
RECORD_ID
PR0545720
PE
2952
FACILITY_ID
FA0005524
FACILITY_NAME
A TEICHERT & SON INC
STREET_NUMBER
20913
Direction
E
STREET_NAME
STATE ROUTE 12
City
CLEMENTS
Zip
95812
CURRENT_STATUS
02
SITE_LOCATION
20913 E HWY 12
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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LSauers
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EHD - Public
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NO. CHEMTECH ANALYTICAL LABORATORIES (916)635-3962 CHAIN OF CUSTODY- LOG-IN <br /> ANALYSIS D P RESULTS VERBAL: <br /> PROJECT NAME 2'- <br /> '7,V ,SdJLu <br /> O <br /> LL z <br /> PAGE CLIENT CHAIN OF CUSTODY# p n Oyu �p\ Yes ❑ No ❑ <br /> ZO Q 2p y DATE BY <br /> OF DATE TIME MATRIX Z U p c��JQ 0P" TO WHOM: <br /> TECH CHEM SAMPLE I.D. SAMPLED SAMPLED ��� =O Q� ��,� PHONE <br /> LD.# <br /> COMMENTS: <br /> e? A P l g7us(_. <br /> L _ Z �W Lae <br /> S <br /> 'dJ <br /> A 6 1."1 <br /> _N 191 ( Nr (ENTAL HEALTH <br /> PE MI USE:RVICLS <br /> Relinquished by:(signa,we) DateMme Received by:(signawre) —TTZ_(AjJ4 L6— <br /> 6 y (,-M <br /> - 2—?q_/ _T4A)1G <br /> Relinquished by:(Sgn Date/Time Received by:(signature �? <br /> Relinquished by:(sgna Datel/Time Recei for Lab tory by: T� <br /> (Signatu ) ` <br /> �-9/ o. � 3l �i <br />
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