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ARCHIVED REPORTS_XR0007959
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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W
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WEST
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2801
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2900 - Site Mitigation Program
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PR0504943
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ARCHIVED REPORTS_XR0007959
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Entry Properties
Last modified
6/18/2020 12:43:03 PM
Creation date
6/18/2020 12:08:17 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007959
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
Tags
EHD - Public
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r �r r rt � rr r r rr r� ■r <br /> Chain o4p ,iivanferr <br /> Custody Record <br /> QUA-412A <br /> Client Protect Manager Date Chain Of Custody Number <br /> �0.r»c.s vnooc . Ss;.c.�c. Kos Ca-�-99 4 n 9L 6 <br /> AddressLL Telephone Number(Area Code)/Fax Number Lab Number'BBI I <br /> D, f-c 5 o rn 01. l��V 1G.200 ep1 t(4—3 -'—S 8®O Page 4 of <br /> City State Zip Code Site Contact Analysis <br /> S�.c,�w ani e G Y4 SgZ.(o `Te.,;,o r <br /> Protect Name Camer/Waybill Number <br /> Contract/Purchase OrderlQuote No <br /> 15 tSa9 -o%-4 <br /> Containers 4- <br /> Sample I D No and Description Date Time Sample Type ynlu Tota!l TYP e No Preservative Condition on Receipt <br /> l0 ' • rian Z. <br /> ID ffi-W--4 1 5 z <br /> Irlmo -Coo 1 IAAN <br /> z <br /> c co a� t <br /> [}E <br /> EUU <br /> E <br /> Special Instructions <br /> Possible Hazard Identification Sample Disposal <br /> ❑Non Hazard ❑Flammable ❑Skin Irntant ❑Poison B u Unknown ❑Return To Client [:].Disposal By Lab ❑Archive For Months <br /> Turn Around Time Required OC Level Protect Specific(Specify) <br /> 29 Normal ❑Rush 1:11 ❑li ❑III <br /> I Rell5ished 6y Date Time t Received By Date T+me <br /> co-1-90, 6:3,3-0 Cxa� 3 <br /> 2 Relinquished By Date Time 2 Received By Rate Time <br /> 3 Relinquished By Date Time 3 Received By Date Time <br /> Comments <br /> DISTRIBUTION WHITE Stays with Sample CANARY Returned to Client with Report PINK Field Copy <br />
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