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ARCHIVED REPORTS_XR0012935
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_XR0012935
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Entry Properties
Last modified
3/31/2020 2:11:32 PM
Creation date
3/31/2020 2:07:02 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012935
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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s. - SI . .� - <br /> ot 4 v riKE Lntvr_, 5CkA1N�UST DYRE[:URD " r <br /> IG'� CONCORD, CA 94520 ` AND ANA 77 �7, <br /> 510 685-7852 LYSIS REQUEST <br /> 800;423-7143 <br /> Company Name: Phone#; 68"D 1 S3 2 /per 17' <br /> + l <br /> 1f ' <br /> �rJ cJM erg Tec- L.a 1 o g y 1 vti c. FAX#:�d(- 5,7 2 -- /b.s6 0 <br /> Company Address: ;,7,5- e.Sa Site Location: <br /> W ❑ <br /> -r�e►+,.pl� ,S�;Te� � CR m m ❑ Ll <br /> ¢ <br /> 7oSa.1; L eGT r'j E�.1 <br /> a <br /> cc <br /> Project Manager. Client Project IJ]: N a a Ll f l <br /> IV✓`pd1N�C�l <br /> 0-)_C,2.0 4a2� LI o m cn m rn a F_ <br /> m LL o U NJ !.I IJ z CO T ( " m <br /> attest that the proper field sampling Sampler Name(Print) � � a [7 in o rJ I i ly r) to d <br /> 0 f1 F.7 O J J <br /> procedures were used during the t <br /> collection of these samples. S o f"I o a o of 01 a N �� a y c <br /> Method vl ° w `� tgn m a m m 17 � � 1=l am b <br /> :L-- <br /> Matrix ❑ r`1 x <br /> Sampling d 6 0 o e Q d d a o W Q f_I > <br /> cc Preserved COv a d f l w 4 o m 1-1 1,7 H <br /> Field GTEL w T N H r 1.I o C) o- <br /> z I I 2 c c 1'I w w m � J n y n n <br /> ~ a ° a 8 11 I I f a o <br /> Sample Lab# a w N ro 1 a l l N a l <br /> a s ¢ W c� `v a 3 ai V <br /> 1� Lai]tJSe d W.,� j w _ =_�° , - �� `Lr N =-w w w' `-V - -ro - n '�^_ �. n.. ("0 -m C14. <br /> - - <br /> Q <br /> only a o U z N w = a t- o d W _w W w -a- W ° <br /> 3 rn a o a O z z z �? ° p a F m m x x - w u4i rv- v W d c� <br /> D t >< <br /> - <br /> - 3' 2- l3y� <br /> sw'4 -/.:,' 0 3 r►rl s <br /> p <br /> 77 <br /> TAT Special Handling SPECIAL DETECTION LIM#TS REMARKS: Y� <br /> Priority(24 hr) XGTEL Contact <br /> Expedited(48 h{) ❑ Quote/Contract. - <br /> 7 Business Days ❑ <br /> Other Confirmation.# <br /> Business Days p P.O. SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot it: Storage Location _ <br /> ., <br /> 0A14C Level C <br /> • '� Ci���Ca �i`� _ <br /> Blue0_ CLP0:....01her❑ _FA _ Work Order 4i:- J - <br /> Relinquished by Sampler: Date Time Received by: <br /> CUSTODY "i 1- Ill 016 lS kms^ <br /> Relinquished by: Date Time Received <br /> _ RECORD o <br /> Rellnquishe by Date Time Received by Laboratory: <br /> ahl 94 102 !40 Waybill 0 <br />
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