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ARCHIVED REPORTS_XR0004033
Environmental Health - Public
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EHD Program Facility Records by Street Name
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L
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LINCOLN
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1426
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2900 - Site Mitigation Program
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PR0527611
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ARCHIVED REPORTS_XR0004033
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Entry Properties
Last modified
3/4/2020 2:20:52 PM
Creation date
3/4/2020 2:09:54 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004033
RECORD_ID
PR0527611
PE
2957
FACILITY_ID
FA0018709
FACILITY_NAME
FORMER DOLLY MADISON
STREET_NUMBER
1426
Direction
S
STREET_NAME
LINCOLN
STREET_TYPE
ST
City
STOCKTON
Zip
95206
APN
16503010
CURRENT_STATUS
01
SITE_LOCATION
1426 S LINCOLN ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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1, �vtir A VL A r k.Jt-x""1Xtx l Y AINALY61LSRL+ ULST FORM <br /> North Market Boulevard Sacramento CA 95834 vice Request No Purchase Order <br /> aEMCOfQM3 <br /> 6) 928-3300 FAX (916) 928-3341 <br /> Project Name IBC-Stockton <br /> Lab SEQUOIA <br /> Project Number 22605-101003 Anal sis R uested <br /> Project Manager Mark Capps .� 16 <br /> o16 <br /> Company EMCON-Pinnacle 4 C) <br /> Address 3939 Cambridge Road,Suite 202 <br /> o � <br /> Cameron Park,CA 9682 a 00 � <br /> Phone (530)676-6881 w X o 3 N <br /> FAX (530) 676-6885 00 <br /> Sampler's Signature x W o <br /> m <br /> � O w <br /> Sample L ample z 1 I REMARKS <br /> I DDate Time I D Matrix HCl HCl Preservations <br /> Container Types <br /> MW-1 ��9 Zc�`3 water 5 3 2 i <br /> MW-2 2 j b water 5 3 2 <br /> RELINQUISHED BY RECEIVED BY RELINQUISHED BY RECEIVED BY <br /> TURNAROUND REPORT REQUIREMENTS <br /> St at re Signature Signature REQUIREMENTS X 1 Routine Repon <br /> g Signature 24 to 48 hr s day 11 Report(includes DUP,MS <br /> ;ted NameSundard(-i at 5+part og 4Uys) MSD,as required,may be <br /> h Printed Name Printed Name Pnnted Name <br /> Provide Yerbil Ynlmmuy R<sutu charged as samples) <br /> Firm1r—de FAX Prell=Luy Resells III Data Validation Report <br /> � <br /> [:irm �� Firmn <br /> G D Requested Repo;Date (includes All Raw Data) <br /> Date/time Datefrime Date(I-une RWQCB <br /> Date�me (MDLs/PQLs/IRACEH) <br /> RELINQUISHED BY RECEIVED BY Special[gstrucilonslComments <br /> Container Types Key <br /> SignaturL Sequoia Analytical 40 ml VOA t <br /> 819 Striker Ave Ste $ <br /> 250 ml LPE 2 <br /> Printed Name Pna Sacto,Ca 95834 500 ml LPE 3 <br /> —0! 916-921 9600 1 liter HDPE 4 <br /> Firm F I„ 500 ml glass 5 <br /> V I liter glass 6 1 <br /> Date/time Date ime 2x6 s/s ring 7 <br /> glass�ar $ <br /> t <br />
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