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ARCHIVED REPORTS_XR0005280
Environmental Health - Public
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EHD Program Facility Records by Street Name
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MCDONALD
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12988
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3500 - Local Oversight Program
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PR0545540
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ARCHIVED REPORTS_XR0005280
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Entry Properties
Last modified
3/13/2020 12:05:07 PM
Creation date
3/13/2020 11:25:15 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005280
RECORD_ID
PR0545540
PE
3528
FACILITY_ID
FA0004175
FACILITY_NAME
TIKI LAGUN RESORT & MARINA
STREET_NUMBER
12988
Direction
W
STREET_NAME
MCDONALD
STREET_TYPE
RD
City
STOCKTON
Zip
95206
APN
13102026
CURRENT_STATUS
02
SITE_LOCATION
12988 W MCDONALD RD
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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i <br /> Forensi( .nalytical (" <br /> Analytical keport <br /> San Francisco.3777 Depot Road, Suite 409, Hayward, CA 94545 • Phone 510/887-8828 . Fax1 / <br /> 5 0 887-4218 <br /> {• Los Angeles • 19443 Laurel Park Road, Suite 101, Rancho Dominguez, CA, 90220 • Phone 3101763-2374 . Fax 310/763-8684 <br /> t <br /> Bu13t Material Analysis <br /> Methods 40 CFR 763, Subpart F, Appendix A (AHERA) <br /> Clients <br /> Blasland, Bouck, & Lee, Inc. Client Numbers 2798 <br /> Report Numbers 239946 <br /> 7599 Redwood Blvd. , Suite 209 Date Received: 08/02/95 <br /> Novato, CA 94945 <br /> Lab Number: 19568200 --- -Date-Collected: 06/16/95 - <br /> Sample Number: Store bathroom <br /> P.O. Num: <br /> Job ID: 05845 <br /> LSite : Tiki Lagun <br /> { Location: Store bathroom. <br /> 1 <br /> L Gross Descriptiont Tan tile and black mastic. <br /> i L Comments: Asbestos in tile ( 10-15%) . Composite reported. <br /> 5 <br /> Microscopic Description <br /> -------------------------------------------------------------- <br /> TOTAL ASBESTOS PRESENT: 10-15 % <br /> Chrysotile 10-15 % <br /> Amosite Non-Det. % <br /> i <br /> TOTAL NON-ASBESTOS FIBROUS MATERIAL PRESENT: Trace % <br /> Cellulose Trace % <br /> Fibrous Glass Non-Det. % <br /> % <br /> TOTAL NON-ASBESTOS NONFIBROUS MATERIAL PRESENT: 85-90 % <br /> ---- ---- ------------------------------- ---------------------------------- <br /> AnaWleal results and reports are generated by Forensic analytical at the request of and for the exclusive use of the person or entity(client)named an <br /> such report.Results,reports or copies of same will not be released by Forensic Analytical to any third party without prior written request from client. <br /> This report applies only to the sample(s)tested.Supporting laboratory documentation Is available upon request.This report must not be reproduced <br /> except in full with approval from Forensic Analytical.The client is solely responsible for the use and interpretation of test results and reports requested <br /> from Forensic Analytical.This report must not be used by the client to claim product endorsement by NVIAP or any agency of the U.S.Government. <br /> Forensic Analytical Is not able to assess the degree of hazard resulting from materials analyzed.Samples submitted to Forensic Analytical are retained <br />' 1 for a period of six months and then disposed of according to all state and federal guidelines. <br /> 5 <br />
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