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2900 - Site Mitigation Program
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PR0518127
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Last modified
5/17/2019 11:50:34 AM
Creation date
5/17/2019 11:27:02 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0518127
PE
2950
FACILITY_ID
FA0013712
FACILITY_NAME
RAYMOND INVESTMENT CORPORATION
STREET_NUMBER
2245
Direction
W
STREET_NAME
CHARTER
STREET_TYPE
WAY
City
STOCKTON
Zip
95206
APN
16336017
CURRENT_STATUS
01
SITE_LOCATION
2245 W CHARTER WAY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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SunStar Laboratories, Inca Chain of Custody Record <br /> 25712 Commercentre Dr <br /> Lake Forest, CA 92630 <br /> 949-297-5020 <br /> Client: AAA a"�"-V-< G,- `V' L�A t^"LRAA4 01 sp�� Date: +Z���� Page:—�� of Z" <br /> Address: ✓�Z6 �• '-�^! Project Name:Z2 WA c�� 1'a�t� C—A <br /> Phone: D— Fax:31 —15-q—O{ciq gCOV ' Collector. �..n r?�o.�40ClientPr ect#: I30IZff' <br /> Project Managen<-hz s._M��Z ✓& Batch M EDF#: <br /> a m <br /> O O N G <br /> XC l6 m # - is <br /> O � m X 0 Y lV <br /> W O O <br /> , .. + <br /> Sample Container N �`o .� <br /> Raw <br /> pieDate Sampl Time Type Type ro CO m 00 m CO Co Co � $$ Comments/Preservative F <br /> 7 tl`. `� H So ? N <br /> r� !� o Izc <br /> -L !Z3 Y XX 119 <br /> 122tNe 120 <br /> t UP. 2J <br /> •_• �p2 it 21 1 <br /> tea, �•n 2'1 <br /> 2- 2S <br /> 48 14RA <br /> quished b : signature) Date/Time R eiv y' sig re) Date/TIwE Total#of containers <br /> $—�j`)3 2. �ZJ`� C� Chain of Custody se /NA <br /> Relinquished-by: (sign re) Date/Time eceived by:(s' tura) Date/Time Seals intact Y /NA <br /> .a . ? ,'" //.•00 Received good condition/cold /-E w. <br /> Relinquished by: (signature) Date/Time Ived by: ignature) Date/Time �--.� STDTA.T - <br /> Turn ound time: <br /> Sample disposal Instructions: Disposal @$2.00 each._ Return to client _ Pickup 03 aSIJ <br /> ,�2y <br /> COC 1314 <br /> -77 <br /> yg-�,� ko[d �•� � <br />
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