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ARCHIVED REPORTS_XR0006656 CASE 1
EnvironmentalHealth
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2900 - Site Mitigation Program
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PR0500097
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ARCHIVED REPORTS_XR0006656 CASE 1
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Entry Properties
Last modified
7/23/2020 3:37:00 PM
Creation date
7/23/2020 3:21:11 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006656 CASE 1
RECORD_ID
PR0500097
PE
2950
FACILITY_ID
FA0001329
FACILITY_NAME
PONTES QUICKI KLEEN CAR WASH
STREET_NUMBER
707
Direction
E
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
APN
22323013
CURRENT_STATUS
01
SITE_LOCATION
707 E YOSEMITE AVE
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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LSauers
Tags
EHD - Public
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r� r� rr r r r r r r r rr r r ■■rr r rr rr �■r it <br /> ( Advanced <br /> CHAIN OF CUSTODY <br /> IRECORD <br /> -_=w GeoEnvironmental, Inc J 1Bi21--Zq3- <br /> Date_k101— Page <br /> 837 Shaw Road -Stockton California 95215- (209) 467-1008 Fax (208) 467-11111 <br /> Client 0Prole ManaW—�—A <br /> er <br /> �I f07 <br /> � Tests Required <br /> Phone Number <br /> ---A�—v <br /> Samplers (Signature) b Invoice <br /> Protect NameAGE <br /> r Client ❑ <br /> 7 ❑ <br /> Sample LocationSample Type <br /> No of <br /> Date Time Water Solid Notes <br /> Number Description Air Conts <br /> Comp Grab <br /> JIT101i G _ $9325 <br /> U <br /> 10 89326 <br /> X- - 89327 <br /> 89328 <br /> 85329 <br /> e inqur y (Sign ref rtaceivedTiy igna ure //�� I (] J T <br /> vfoC 0,9G 'M'-T4,F 011 TR <br /> Relinquished by (S nature) Racery d b oate(rime <br /> �iQPLIi IC!Pd __ AFF'1;(I f iIRT <br /> Relinquished by (Signature) n ecelved b EeI k or r for field analysis SI natura DafalTrrne <br /> d..r r fIF AMC-iJ� P�i fl�Y r '�, y y ( 9 ) <br /> Dispatched by (Signature) DateffimeReceived for 1_a oralory by0 to mW <br /> V - <br /> Method of Shipment rl Laboratory Na e _ <br /> Special Instructions i Wwvby aulhorize the performanco of the above Indicated work <br /> — �� T��( � <br />
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