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SITE INFORMATION AND CORRESPONDENCE
Environmental Health - Public
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2900 - Site Mitigation Program
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PR0009040
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
10/1/2019 4:59:08 PM
Creation date
10/1/2019 4:49:10 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0009040
PE
2960
FACILITY_ID
FA0004009
FACILITY_NAME
CALIFORNIA FUELS/D ATWATER
STREET_NUMBER
838
STREET_NAME
MOKELUMNE
STREET_TYPE
ST
City
WOODBRIDGE
Zip
95258
APN
01509082
CURRENT_STATUS
01
SITE_LOCATION
838 MOKELUMNE ST
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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Canonie Environmental Services Corp. <br /> Field Sampling Log <br /> Project Name -T �o f QF �� 1 Project Number_ '� , ? <br /> Sampling Location(&Outni« 1uc(r, Peirjeumftal S M c 1 vw...P 5- <br /> (000 <br /> Contact person Phone <br /> Sample I.D. Matrix Type of Container No. Field Data4ot <br /> 3 ' <br /> H - <br /> ow3 6ecGe <br /> Site Diagram. (Include Compass Bearing) Y <br /> Date-.- 3- Is 4, �--,� ..x.--�--y-- ► •,,—�,-,, �. <br /> Time Depart. : ?;i5 k J <br /> Time Return: to-Ic, <br /> Mileage: �J_ 143,( „�,,(Pc, <br /> 1 ` I <br /> Sampling Method: O ReyulQ,- <br /> Remarks FD <br /> urn L EADEO <br /> a_ c.K c�P � ic.keT =Ple <br /> RD (7 'j 2�c1..1K. <br /> i <br /> P <br /> Sampler Signature Date °`sP <br />
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