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ARCHIVED REPORTS_XR0008019
Environmental Health - Public
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EHD Program Facility Records by Street Name
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P
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PACIFIC
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5110
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2900 - Site Mitigation Program
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PR0505897
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ARCHIVED REPORTS_XR0008019
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Entry Properties
Last modified
3/31/2020 2:13:46 PM
Creation date
3/31/2020 2:06:09 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008019
RECORD_ID
PR0505897
PE
2950
FACILITY_ID
FA0007071
FACILITY_NAME
SEARS ROEBUCK & COMPANY
STREET_NUMBER
5110
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
CURRENT_STATUS
02
SITE_LOCATION
5110 PACIFIC AVE
P_LOCATION
01
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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40WMKE MIT,SUIRIM 0 L.AM-OP-MSTRiMMD 03 5 6 <br /> G CONCORD, CA 94520 AND ANALYSIS REQUEST <br /> (510)685-7852 <br /> (800)423-7143HER <br /> , , <br /> Company Name Phone# 8ar S'32�- /C)0377M <br /> Cr Kul -lam.►' ���r�a oc�y + .�v�c. FAX# �a I �3 — /bS6 U ' s raf I 1 <br /> Company Address �,7 E.So Site Location I f� L] o <br /> 7'-�2w�1^e-.} S,,;Te Seck S/ cx Tn Gf� r0 ❑ f f fl d) H oe g <br /> Q.ci 1, �Q 6 L l I N V �' -1 I I ' <br /> Project Manager hent Project ID (#) y ' +' e a r �' <br /> �Y`QtsN 'tC2o]_D Oaf` W O D Lu f I l) z z l 17 11 tr <br /> /Cit CO nr l l ,n c Cl <br /> attest that the proper field sampking Sampler Name(Print)R/ e a N o M f l I l o �� I J $ v I I <br /> procedures were used during the s � 0 � `� � T � f I I I m a }ra- u � � r` c <br /> 3 o O in C1 Ln n N o 0 0. d ❑ a y 11 0. <br /> collection of these samples L I @ W . �, M 12 0 1-j N N I_1 n' o = L) n <br /> Method N 8 0 2 e `� o d a cG Cl U. <br /> Matrix Sampling o n �, � ;_l W a- o o i I I� �, LN n a u <br /> Field GTEI. W Preserved ll W W co W _ n , ll <br /> z r N 0 ° 0 °p g ESI 11 I1 11 a a <br /> Sample Lab# a W �; ra M " 0 0 4 o N N a x <br /> ID (Lab Use o h ❑ o W _ g o aw "'z W W W 'z m a a a a a a a R � <br /> y v a a s z in �' a t< �J a r a a ❑ a a a a d a a a u <br /> only rOn a N a O z x T 5% 0_ ❑ r co m x x 0 r W W W W W W w W W >- w U + O C� <br /> 11 X $�,0 131 <br /> 3, 2- 13HS <br /> usMir <br /> Y <br /> --7 <br /> I <br /> TAT Special Handling SPECIAL DETECTION LIMITS REMARKS <br /> Priority(24 hr) XGTEL Contact <br /> Expedited(48 hr) ❑ Quote/Contract# <br /> 7 Business hays d Confirmation n <br /> Other SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot++ Storage Location <br /> Business Days ❑ PO z 0 C <br /> QAIdC Level r Ci <br /> Blue© CLP❑ Other 0 FA Work Order 11 <br /> Relinquished by Sampler Date Time_ Received by <br /> CUSTODY I i�`t� U�� �S <br /> Relinquished by Date Time Received <br /> RECORD WJbk -6 -1k 0 { <br /> Reimquishe by Date Time Received by Laboratory <br /> 0/l/ q 4d Wa bill 11 , <br />
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