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ARCHIVED REPORTS_XR0004599
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0507835
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ARCHIVED REPORTS_XR0004599
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Entry Properties
Last modified
3/5/2020 12:41:15 PM
Creation date
3/5/2020 12:01:29 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004599
RECORD_ID
PR0507835
PE
2950
FACILITY_ID
FA0007793
FACILITY_NAME
SUPER STOP MARKET
STREET_NUMBER
290
Direction
N
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
95336
APN
22309101
CURRENT_STATUS
02
SITE_LOCATION
290 N MAIN ST
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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C4010g&AI7'ecWcs lac. Page i of ` <br /> 11417th Street _. <br /> Modesto,CA Chain Of Custody <br /> (209)5224119 F-ax 522-4227 <br /> I-malt¢geologLealtecWcs@sbcgt06at net Analysis Requested Laboratory Name and Address <br /> Project# 'hent/Project Name <br /> 2. Z CAYIA0-1.0, (SupeyLSLS U 0) <br /> Site Address G <br /> "tn N y 'jr t TFC-A0 Purchase Order <br /> Global tb No a 0`77 + ,16cl—T <br /> �" � EDF Report. [des ❑ No <br /> Sampled By(print and sign name) c c <br /> 1 Turnaround Time, S=Standard <br /> S o1 1 days 2 day,5 day <br /> Date Time Field I,D. 5ample I.D. Z g Remarks <br /> t7 7 006 W13 INt -r M416 <br /> 1+ <br /> Qshed <br /> slgnatu Date Time Ke--cel signature} Date <br /> �5 A�3 Time <br /> igns r <br /> ate G Time ve ignatur Data' Time <br /> ignature] <br /> Date Tlme Received ts}Cre} Dat 17me <br /> Please return cooierlice chest to Geological Technics Inc. <br /> Rev 4/2004 <br />
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