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ARCHIVED REPORTS XR0013118
Environmental Health - Public
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EHD Program Facility Records by Street Name
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ELEVENTH
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1755
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2900 - Site Mitigation Program
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PR0515454
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ARCHIVED REPORTS XR0013118
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Entry Properties
Last modified
11/19/2024 10:19:10 AM
Creation date
12/14/2018 4:56:34 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0013118
RECORD_ID
PR0515454
PE
2960
FACILITY_ID
FA0012157
FACILITY_NAME
POMBO REAL ESTATE
STREET_NUMBER
1755
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95376
APN
23217020
CURRENT_STATUS
01
SITE_LOCATION
1755 W ELEVENTH ST
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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TMorelli
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EHD - Public
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K� N-OF-CUSTODY RE , ORD .,;;.N° Date lt Pa , ur <br /> - � - ge <br /> Project No.: ANALYSES. <br /> "I wo REMARKS <br /> Samplers(Signatures): Additl8nal Comments <br /> a a nCi <br /> m <br /> •� - - ago CO _c 3 <br /> m m 1�1 ')N � L JY�t'} v <br /> Date Time Sam le 0 Number w w w w <br /> ° Intf � <br /> ` U in` 4 2 <br /> 1 <br /> yx x y Ef�25�82-a3 <br /> , <br /> +1 �i <br /> >T' <br /> Turnaround'time: Results to. <br /> Tot.1,11 of containers: <br /> ellnqu►shed -(si nature} Date liriq hed by pater Date" Relinquished Gy(signature): Date: Method of Shipment' <br /> Vyx <br /> Printed NamO, ' Time Printed dame;.• time:, Printed iti ine: a Trge• Laboratory Comments and Log Yo.: <br /> '�..�j t St .it r tir '•a- F• rw 4R ` v <br /> Company. _ .. r. Company: �• Company:_ <br /> Received by(signature): Date: Received by(signature): Date; Received by(sin re): Date: <br /> V. <br /> Printed Name: Time Pn ird Naive: Time, Printtjd Name: Time: <br /> NSE <br /> Company: i ComPany Q Corn <br /> pan y <br /> ? ll`3p r j <br /> e i S ` _.T''` Ot30MATgrX,= �bild `iI7 �J1.2,' <br /> i Forrn4iPF]012'(q@4ls�d i2J✓�S� < § J' <br /> y <br /> x <br />
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