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ARCHIVED REPORTS_XR0005297
Environmental Health - Public
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EHD Program Facility Records by Street Name
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M
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MARIPOSA
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2132
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2900 - Site Mitigation Program
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PR0541650
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ARCHIVED REPORTS_XR0005297
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Entry Properties
Last modified
3/11/2020 4:45:41 PM
Creation date
3/11/2020 3:01:01 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005297
RECORD_ID
PR0541650
PE
2960
FACILITY_ID
FA0023868
FACILITY_NAME
FORMER USA GASOLINE SERVICE STATION 110
STREET_NUMBER
2132
Direction
E
STREET_NAME
MARIPOSA
STREET_TYPE
RD
City
STOCKTON
Zip
95205
APN
1730635
CURRENT_STATUS
01
SITE_LOCATION
2132 E MARIPOSA RD
P_LOCATION
01
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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K 2795 2nd Street Suite 300 ROW <br /> Davis,CA 95616 <br /> Analytkal uc Lab 530 297 4800 SRG#1 Lab No Page 1 of <br /> Fax 530 297 4802 — <br /> Projed Contact(Hardcopy or PDF To) California EDF Report? OYes El No R Smith Chain-of-Custody Record and Analysis Request <br /> Company/Address Sampling Company Log Code Analysis Request TAT <br /> Horizon Environmental Inc HEIE <br /> Phone# Fax#- Global ZD El91B 939-2170 916 939-2172 T0607700064 xo 12 hr <br /> Protect/! P O # EDF Deliverable To(Email Address) ❑ <br /> 1011042 Contract o <br /> Protect Name Sampler Signature c m w N 24 hr <br /> USAP 110 <br /> v e <br /> 1 ~• � 4 _ � N � W � 4 � � ❑ J <br /> Protect Address Sam Container Preservative Matrix ® a _ <br /> c� 3 a 48hr � <br /> W <br /> Stocktona a W COEl <br /> ° W x a 2 72 hr <br /> LU w <br /> 3 3 = w ✓ <br /> Sample Designation Date Time in o a (7 H x r z v� �, r` > > } F 3 <br /> MW-1 2/27/2oo6 1 3 x 1XI x x x X1 x <br /> MW-2 2/2712oo6 31 1 1 1 x I x X1 x x xi I I I I x 0 <br /> V MW-IP =7/2006 IZ 31 1 Ix x x x x x <br /> x <br /> MW-2P 2/27/2006 31 1 1 x x I I x x X1 x x It,MW-3P 2127=06 MCA 3 x x x x x x x <br /> VI►-4P m7rmm 4 3 x x x x x x x <br /> MW-5P 2/27/2006 11141 3 x x I x x x x x O <br /> MVH-6P 2/27/2006 WN 31 1 x Ix I Ix x x x x <br /> 16 <br /> Relinquished by Date Time roed <br /> Remarica Standard TAT <br /> Dfar�d►r► �.h 2�'L�O� i1�'X? <br /> Relinquished by Date Time Rereived by <br /> Bill to Horizon, G Barker <br /> Relinquished by Date Time Received by Laboratory For Lab Use Only Sample Recelpt <br /> WTemp•C InEtials Data Time Therm to# cna.a P <br /> DlstriWm While-Lab Pink-origmator (l11 ! NG <br /> Raw 0511105 <br />
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