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FIELD DOCUMENTS
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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WILLOW GLEN
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13751
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2900 - Site Mitigation Program
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PR0009025
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Last modified
5/19/2021 2:51:15 PM
Creation date
5/19/2021 12:24:17 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0009025
PE
2960
FACILITY_ID
FA0004055
FACILITY_NAME
LATHROP GAS DEHYDRATOR
STREET_NUMBER
13751
Direction
S
STREET_NAME
WILLOW GLEN
STREET_TYPE
RD
City
STOCKTON
Zip
95206
APN
19105010
CURRENT_STATUS
01
SITE_LOCATION
13751 S WILLOW GLEN RD
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
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SJGOV\dsedra
Tags
EHD - Public
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Ship To: <br /> CHAIN OF CUSTODY RECORD <br /> Pacific Gas & Electric Company W"Jc4 <br /> 3400 Crow Canyon Road, San Ramon, California 94583 <br /> (510)820-2000 Attention: Phone:�0-�3/-1��8Page Z of 2- <br /> oa ' <br /> Job Number: Project Name: Project Manager: <br /> G�1��7�93-�-TEs �t,�,(b �� r� .�•,C/i1. ah ,(�° e�`� j <br /> Samplers: ignatures) Field Team Leader: <br /> SAMPLE <br /> NUMBER DATE TIME STTYPEE SAMPLE INFORMATION oRS ��� �flko9�Z�'U �'� REMARKS <br /> C <br /> !o— 7 �7 S Z 9z So t c ONS / ✓ <br /> X3.0 <br /> /3-9 (z.S-Fri ✓ �' tL <br /> /3-9 (-7..r/-r) <br /> ✓ ✓ <br /> o,uc-tt- <br /> Rv D raC_L- <br /> x 8-� �w�rte) ✓ R�I&VEv C Q c <br /> �( /3-� �uw7�) � / 1J Goon con»fno►� <br /> y� /3-8 /(warren-) .� ✓ <br /> 7;C/P 8L4NK 40 f <br /> Relin d By:(Signature) Date<Tme: Receiv Zat ) Date?ime: Ship Via: <br /> //WL(2/Z 0a I/A S Z <br /> Relinquished By:(Signature) DateRme: Received By:(Signature DateRme: <br /> BUAirbill Number: Date: <br /> Relinquished By:(Signature) DaterTime: Received By:(Signature) DateRme: <br /> DISTRIBUTION: Original Accompanies Shipment;Canary Copy to PG&E;Pink-Sampler NOTE: Samples are discarded 30 days after results are reported unless other arrangements are made. 60006997/Gl TI97 <br />
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