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ARCHIVED REPORTS_XR0006171
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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Y
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YOSEMITE
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1257
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3500 - Local Oversight Program
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PR0545949
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ARCHIVED REPORTS_XR0006171
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Entry Properties
Last modified
9/29/2020 10:14:40 PM
Creation date
8/6/2020 9:46:57 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006171
RECORD_ID
PR0545949
PE
3528
FACILITY_ID
FA0003707
FACILITY_NAME
AHMEDS SONS INC
STREET_NUMBER
1257
Direction
W
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
APN
20015015
CURRENT_STATUS
02
SITE_LOCATION
1257 W YOSEMITE AVE
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
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LSauers
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EHD - Public
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❑ Yes y�J7c3� <br /> Fax copy of Lab Report and COC to Chevron Contact 0 No Chain—of—Cu stod "Record <br /> Chevron Fad*Number 9-1848 Chevron Contact (Name) Brett Hunter <br /> Facility Address 1257 osem>_te West, anteca (Phan°)_(510) 842-8658 <br /> Chevron USA. Inc. <br /> Consultant Protect Number 9VUt31to—Z)' Laboratory Name SUPERIOR <br /> P 0 BOX 5004 BLAINE TECH SERVICES INC 6177480 <br /> San Ramon, CA 94583 conwnant Nom. � Laboratory Release Number <br /> FAX (415}842-9591 Address 985 Timothy et <br /> Dr , San Jose — Samples Caneed by (Name) Broth 8t � <br /> Projoct Contact (Name) Jim Keller Collection Dale £illb lel <br /> (408) 995-55 408) 293-8773 <br /> (Phone) ax Number) Signature„ <br /> Analyses To Be Performed <br /> • <br /> 66 0� qq c <br /> z tV V i 'Un E Z O <br /> +� <br /> �0 <br /> cR 5 i m3 r SI Remarks <br /> C.- <br /> C- <br /> C-L 3 " 1110 X <br /> C.-3 3 to ty x <br /> �H zr — <br /> i'A <br /> l <br /> V, ' out jo3,; pace <br /> [.cr nuttl 5 (c la <br /> I r q <br /> a RaRriquiahed By (Signature) AWnizaUan Date/nme to j R•aeMed By (Signature) Or antzatlon Date/nme Tum Around Time (Clrels C") <br /> wt V G 24 Hre <br /> R bqutehsd W (Slgnature) Organization Date/Time 'Feeelwd By signature) 0rgonizat1on Dote 48 Hro <br /> 6 Gaya <br /> �iZO10 DM <br /> el[nqulehed By (Signature) omonlzaticn 4001eve F Laboratory By (Slq re) Date/'I me <br /> �w l�o l7- <br />
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