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ARCHIVED REPORTS XR0006449
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 XR0006449
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Entry Properties
Last modified
8/21/2019 4:22:58 PM
Creation date
8/21/2019 2:48:39 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006449
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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Reporting Iniormo A S ) , <br /> 1 Client <br /> WZCKLAND PROPERTIES Amel'Ium Ellwionmental Nelivoik AEN Page of 1- , <br /> Address P. o. 8o x—136-48 344()Vincent Road,Pleasant Hill,CA 94523 <br /> SACRAMENTO , <br /> CA 95853 -4648 Phone(510)930-9090 REDDEST FOR ANALYSIS/CHAIN OF CUSTODY <br /> fAX(510)910 0256 Lab Job Number Z0 <br /> Contact _,7DHfV MARGOWSKZ Lab Destination �- <br /> All Contact <br /> Date Samples Shipped <br /> Address Report To Send Invoice To Lab Contact <br /> Date Results Required <br /> 2 WESTERN GEO-ENGINEERS 3 SAME AS ##1 Date Report Required <br /> 1386 E- REAMER STREET Client Phone No <br /> WOODLAND , CA, -6 0 0 3 Client FAX No <br /> ANALYSIS <br /> Send Report To i or 2 (Circle one) Grl <br /> Client P O No Client Protect I D No 3 <br /> Sample Team Members �� <br /> Lab Client Sample Air Date/ Sample No Type v Er, <br /> Number Identification Volume Time Type. Pres of of �v <br /> Collected Cont Corti � � Comments/Hazards <br /> i <br /> Relinquished by DATE TIME Received by �, _` DATE TIME � <br /> (Signature) -- t _Q7 if 2Jr (Signature) S 3-/1- /V-25- <br /> Relinquished by DATE TIME Received by DATE TIME <br /> (Signature) 3- rf- 7 1-3.:: (Signature) <br /> j Q-7 13 Std <br /> Relinquished by DATE TIME Received by DATE TIME <br /> (Signature) (Signature) <br /> Method of Shipment Lab Comments <br /> 'Sample type(Specify) 1)37mm 0 8 pm MCEF 2)25mm 0 8 pm MCEF 3)25mm 0 4 pm polycarb filter <br /> 4)f'VC filter diam pore size 5)Charcoal tube 6)Silica get tube 7)Water 8)Soil 9)Bulk Sample <br /> 10)Other 11)Other <br /> COPIES WHITE JOB FILE YELLOW PROJECT FILE PINK CLIENT <br />
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