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ARCHIVED REPORTS XR0012611
Environmental Health - Public
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EHD Program Facility Records by Street Name
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P
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PACIFIC
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6425
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2900 - Site Mitigation Program
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PR0519189
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ARCHIVED REPORTS XR0012611
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Entry Properties
Last modified
8/21/2019 2:42:07 PM
Creation date
8/21/2019 2:14:26 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012611
RECORD_ID
PR0519189
PE
2950
FACILITY_ID
FA0014347
FACILITY_NAME
CURRENTLY VACANT
STREET_NUMBER
6425
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
09741031
CURRENT_STATUS
02
SITE_LOCATION
6425 PACIFIC AVE
P_LOCATION
01
QC Status
Approved
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EHD - Public
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3 <br /> McLaren Analytical Laboratory 209931 <br /> Chain sof Custody Record <br /> 'Ic 01 <br /> f <br /> � � � r <br /> PROJECT DESIGNATION � C_ SAMPLES TAKEN BY:* <br /> SAMPLE TYPE <br /> AREA SAMPLELOCATION DATE TIME WATER SAMPLE TYPE <br /> COMP GRAS SOIL NO. CONTAINERS •r•�NALYSiS <br /> 1� P Gil'$tOUIRED <br /> 0? YIN <br /> Q <br /> l <br /> -./'V S� F P9 pjc) <br /> fLj Com. 5L <br /> GIcJ S'<1� 1G� Y <br /> r <br /> ?t 1 r<r- <br /> FIELD DISPOSITION; <br /> IMMEDIATE DELIVERY Q <br /> - STORAGES] REFRIGERATOR ID <br /> SECURED ❑YES - <br /> FOEEZER ❑ to ❑NO <br /> RELINOWS D B ;• <br /> � RECEIVED 13Yr DATE/TIME , <br /> RELINQUISHED 8Y:' �Ssz) <br /> RECEIVED 8Y:' DATE/TIME <br /> RECEIVED FOR LABORATORY BY;. 'DATE/TIME <br /> METHOD OF SHIPMENT: <br /> •:rte_ <br /> - - <br /> LABORATORY DISPOSITION: <br /> IMMEDIATE ANALYSIS Q STORAGE❑ REFRIGERATOR❑ 117 5" 3 SECURED <br /> FREEZER ❑ ID ❑ ❑ <br /> CABINET Q ID YES NO <br /> PRINT NAME AFTER SIGNATURE <br /> rk McLaren Environmental Engineering <br /> 11101 White Rock Road,Rancho Cordova,CA 95670 (916)638-3696 <br />
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