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ARCHIVED REPORTS_XR0012936
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_XR0012936
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Entry Properties
Last modified
3/31/2020 2:11:21 PM
Creation date
3/31/2020 2:07:34 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012936
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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= = = = W = = = = M 1� <br /> A, 4080 PIKE LANE, SUITE C CHAIN-QF-CUSTODY RECORD <br /> GTE CONCORD, CA 94520 AND ANALYSIS REQUEST 31257 <br /> (510) 685-7852 <br /> [,1 (800) 423-7143 <br /> ii�IA IOYw 141111 IAC <br /> Company Name Phone 0 oI <br /> / y T" ���. <br /> v 4FAX 0 7 1r <br /> CUP <br /> f Site l-ocatton .;ears 5T—k-on CA m U <br /> �7 / F.SQI<.7V 7 r"4e/!- , s.1,Te 7; / 5T I a-� f I I , , IRS " <br /> SKI r 4-L Cl7F r<� 0.� t����� "vi In u' Cc r t <br /> Project Manager Client Pro ect ID (M) _ <br /> I 02d'1� ra v } = t o a '� <br /> C r le-e,1 �fPc�r.t1� PLOP o I l I I rn fn o I <br /> !aElest that the proper 11a1d sarnpling Sampler Name(Print) t- ,e e �j, e I �; 1 I 1�! i <br /> procedures were used during the J n rd <br /> A o t n 1 1 o a o r.1 I <br /> t` °oof hese samples 7calletitlon O l' <br /> ,p O p n w v l C I U <br /> Il m al M f h Q Q S' U r� y <br /> Method W n d � o � � I _ n <br /> 1n Matrix Sampling o 2 g o a o n Q a n i j > e <br /> ¢ Preserved ca a IL a 1. iii a I_t l I 11 a` N <br /> o a cv c 11] 111 a1 4 d `° a <n w N t l v <br /> Field TE Z , -_ _ fl C L Pt I I_1 J J m <br /> �7Sample — T ,- cv H a o o I J I I a s IJ n U <br /> Lab# a �, 1 b � <br /> U I- ¢ ¢ _ ¢ LD a m '� � � a o o u c ni � � x 5 m � n�mi g <br /> IQ �Lat)Use ul ❑ o lJl p ut i W w w x a o 10 m W Ic o <n to O x <br /> C.J = G UJ a x"" F LL1 W y in F ¢' n n <br /> l7rtiy ¢ a O i i y z" I ;f a r ' ti - n [� a a a n ri a 4 u a d a O1 0 <br /> _ ° a' O F r� Mn = 2 O F vl W W w W w w W W F cv V J 4 U <br /> r__ O <br /> s i <br /> .I <br /> co <br /> N - — <br /> CID = I <br /> co TAT Special Handling SPECIAL DFTECI ION LIMITS REMARKS T <br /> Pnordy(24Ill) ❑ GrEL Contact , 7 I -,f <br /> Expedited(4A hi) ❑ Ouote+Contract 4 E \ f <br /> 7 Buaimess Days ❑ Conlirinatlon N <br /> Other __ _ `rte <br /> n _ SPECIAL REPORTING REQUIREMENTS 1 ab Use fln! Loi; St rage Location <br /> Puseness Days ❑ PO 4 Y <br /> ILevel Fi k! ��`e,.r���n l C f Of Ol9 - Pb(5- <br /> Nue F CLP C Other] _ �- FAX G7� S� C 1 J4o•k Order N Cy 0jP0l4 w - Z Lf Hr IST <br /> Relinquished by Sampler f , �� Ilia Time Received by <br /> `STODY ,�-r-L` -'' i� �� ��Frs-- t� t - <br /> •� IILl Rotinquished by Date I into Flac ivrd by <br /> RelincIiashed by Date Time Rer.aweel by Liborrtary <br />
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