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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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HAMMER
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1648
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2900 - Site Mitigation Program
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PR0518553
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FIELD DOCUMENTS
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Last modified
1/29/2020 5:40:15 PM
Creation date
1/29/2020 4:16:23 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0518553
PE
2950
FACILITY_ID
FA0013967
FACILITY_NAME
KIMCO REALTY
STREET_NUMBER
1648
Direction
E
STREET_NAME
HAMMER
STREET_TYPE
LN
City
STOCKTON
Zip
95210
APN
09428014
CURRENT_STATUS
01
SITE_LOCATION
1648 E HAMMER LN
P_LOCATION
01
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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Nashville Division Phone:615-726-0177 To assist us In using the proper analytical methods, <br /> TestAmeri*qq2960F st r 3721Mn Fax: 615.726-3444 is this work being conducted for regulatory purposes? <br /> Compliance Monitoring r; <br /> �p� Client Name Client#: <br /> �/yPi�7— Address: 2301 �E�ttpSZN S'�. T Project Name:�C—.&aoVe-r4g?- hkir- --- mm ;6 <br /> City/State/ZipCode: r Project#; 610. Q <br /> Project Manager LDENNo.ui r~r-A o.i' Site/Locadon I0����51-OC46-ro State: <br /> Telephone Number. NS-0) (pCI )-O 3 1 _ Fax�oo�to t I q�3'.7 Report To: -NC%:L t4A,z^aJ Mrt l�t w� CA <br /> Sampler Name: (Print Name) I Invoice To: �LA 1�6N p�7-L I .1QAy`t; I tS(JUQu G hl-L D2 11(:R— <br /> Sampler Signature; quote#: )'ZQ N 0 f PL y,40 PO#: 3679Q5` <br /> Matrix Preservation&#of Contain Ana For: <br /> TATStandard a None $ <br /> Rush(surcharges may apply) a'a O <br /> yt � y � �Level 2 <br /> Data Needed: S DAA U) (Batch <br /> Level3 <br /> Fax Reautta: O N U d Other. 4 <br /> x p � c v' <br /> SAMPLE l❑ " °x u $ '�. 5 <br /> REMARKS <br /> 93OWS-- ) 7 /boZ 0?►moi C7 S <br /> cz— .i <br /> &3 PL-- m O <br /> Is HL-Z IC00 <br /> L )4L-3 <br /> Special Instructions; LABORATORY COMMENTS: <br /> Init Lab Temp: <br /> Ree Lab Temp- <br /> 7114,10z— flan `] <br /> In ul Date: Time: R Q Dat I Tlyd ,Q 5 <br /> Custody Seals: Y N NIA <br /> Rerin ulshed BY: Date: Time: Received By-, Bottles Supplied by Test America: Y N <br /> Date: Time: <br /> Relinquished 8 Date: Time: Received-B <br /> Date: Tlme: 'Method of Shipment: <br />
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