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FIELD DOCUMENTS_FILE 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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PR0504943
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FIELD DOCUMENTS_FILE 2
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Entry Properties
Last modified
6/17/2020 4:03:31 PM
Creation date
6/17/2020 3:11:55 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
FileName_PostFix
FILE 2
RECORD_ID
PR0504943
PE
2951
FACILITY_ID
FA0004032
FACILITY_NAME
AMERICAN MOULDING & MILLWORK (FRMR)
STREET_NUMBER
2801
STREET_NAME
WEST
STREET_TYPE
LN
City
STOCKTON
Zip
95204
APN
11709001
CURRENT_STATUS
02
SITE_LOCATION
2801 WEST LN
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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LSauers
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EHD - Public
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Chain of Custody Record <br /> Page of <br /> Fae Name: Fortner American Forest Pmduas Tar : <br /> Da-s$e Time: <br /> Site Name: American Forest Psuducts Off-site Time:URS Tom, <br /> Sky Conditions: <br /> 2101 Weal Ime,Storkee,CA Meteorological Events: <br /> Requested Due Date(mrWddlyy): Standard TAT Watd 3 e17 Direction: <br /> Lab Name:KifrAcialytical Facility Address: 2801 West lane ConFU1mtlC0ntra01ar: <br /> Address:2795 2nd street Sane 300 Stockton,Caliromia Address: 2870 Gmeway Maks Drive,Suite 300 <br /> Davis,CA Site LAVLong, NIA <br /> Sacrmnontq CA 95833 <br /> Lab PM: Caldomia CdobaL ID No.: CoussullaatlContmetor Pro'ecl No.: 17122736 <br /> ToWax:530.297.48001530.297.4802 Earns Project No.: N1A CenaaBanVC'onbactee m Tory Mindlalg <br /> Contact: Site Des tma: Tele/Fax; 916 679.2000 J 916.679.2900 <br /> Address: Phase/WBS: ort Type dr,gC Ievei; Standard <br /> Sub PhasdTask: Ambtical E-mail EDF To: Ton Mmdlm L7RSc .corn <br /> Tole/Fax:I Task Code:07003 Inwice to URS <br /> Iwb Settle Order No: Matrix X container&rd preservative Regaested Analysis <br /> y <br /> Q' <br /> - u <br /> a <br /> z <br /> Sample Description G l.abewtery No. <br /> — Comments <br /> r 2�`'v :nt ase t Mo <br /> g <br /> ad A D <br /> 1 UM—W-2 ILl^ X 5 s T 3 2 p, <br /> 2 DMW-5 ID X 5 5 3 2 O� <br /> 3 DMW-6 t III's X 5 5 3 2 <br /> 4 MW-9 �+ 1 X 5 5 3 2 <br /> 5 MW-9-D ( X 5 5 3 2 (j <br /> X 5 <br /> 7 DMW-11 X 5 5 3 2 <br /> 8 DMW-12Lf5 X 5 5 3 2 p <br /> 9 MW-13 ht_O, 5 5 3 2 M <br /> 10 DMW-l4 X 5 5 3 2 01 <br /> 11 TB-1 c+ X 2 2 l I Hold 10 <br /> 12 EB1 �1 X 5 5 3 2 11 <br /> Saar let s Name: m xei. v abrin a ARi1e1M ewe 15m. <br /> Acer ed By!Alffielioa Det. 71.. <br /> ]rile Com an : <br /> ,STII Cnt Date: <br /> enc Method: <br /> Shu ent Trwkin No: <br /> 9 ectallnetractiona: <br /> Fant--dy Seals In Place Yes No TernD Blank Yes No Coder Temperahire on Receipt_oFIC Trig Blm;Yes jNo <br /> �-a 1o�3109 <br /> 0-700X l l 12- <br />
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