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SU0009625 SSNL
Environmental Health - Public
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SU0009625 SSNL
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Entry Properties
Last modified
12/2/2019 2:18:46 PM
Creation date
9/4/2019 10:17:00 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SU0009625
PE
2622
FACILITY_NAME
PA-1300054
STREET_NUMBER
26781
Direction
S
STREET_NAME
BANTA
STREET_TYPE
RD
City
TRACY
APN
25210001 02
ENTERED_DATE
4/22/2013 12:00:00 AM
SITE_LOCATION
26781 S BANTA RD
RECEIVED_DATE
4/19/2013 12:00:00 AM
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\wng
Supplemental fields
FilePath
\MIGRATIONS\B\BANTA\26781\PA-1300054\SU0009265\SS STDY.PDF
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EHD - Public
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CHAIN OF CUSTODY <br /> W ENVIRONMENTAL AND ANALYSIS REQUEST DOCUILIENT <br /> qLw <br /> Lab Num lry TEST DESCRIPTION AND ANALYSES REQUESTED <br /> gime Live Oak GaoEnvimnmental lif� <br /> Cintomer Number: 3016608 <br /> Address407 W.Oak St. <br /> Lodi,CA 96240 <br /> phone. (209)369-0375 Fax (209)369-0377 s <br /> Email Addresel a"Y0109s10dl.com <br /> Concoct para,,: Abby Ra= <br /> Project Name. Robertson Property,26931 5,Banta Rd.,Tracy <br /> Paehue Order Numbe,. <br /> Mate Number:.'-_._�_ h [i es5 <br /> Sampler(s). Jessen Welch � / , = <br /> SanplingF _ Pickup Fee', i <br /> Compoeirce Setup Date. _ Time', & V <br /> 16 <br /> Semp Location Description DareTime -& 6 A '] <br /> 'Nom, 5mnpled Sampled E I� 4 <br /> 0 Travel Blank 14 V G 2 1 G I X <br /> Domestic Well G 3 PIG P DW SRC O 4 X X <br /> Remarks ?R�� <br /> ed Date Time inqui+lied Do Time Relinquished Date. Time <br /> 13 17Z-7 ��9 3 IWO <br /> Py. DateTime dBy' Da "I''m 3(u31n 1zz-7 3�?i�3 �7u�' 3 Gl <br /> Corporate OrnOae 8 LNrnnmry Office t"Wid cry Office 6 LaboratoryField Office <br /> 853 Corporation Street 2500 Slapecoach Road 583 E Undo Avenue Vmalia,CilSanta Paula,CA 93090 Stockton,CA95215 Chico,CA 95928 TEC.559034-0473 <br /> TEL 805/3922000 TEL 2091042.0182 TEL 5301343-5818 Mobile.550P37-2309 <br /> FAX 800/5254172 FAX 20"42-0423 FAX 530/343-3807 FAX 559/734-8435 <br /> CAJjNELAP Ce,Meatlon No,01110CA CA ELAP Certification No,1563 CA ELAP CmtHlca on No.2870 <br /> J <br />
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