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ARCHIVED REPORTS_XR0005474
Environmental Health - Public
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EHD Program Facility Records by Street Name
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N
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99 (STATE ROUTE 99)
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19256
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2900 - Site Mitigation Program
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PR0540323
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ARCHIVED REPORTS_XR0005474
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Entry Properties
Last modified
11/19/2024 1:50:28 PM
Creation date
4/8/2020 3:37:21 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005474
RECORD_ID
PR0540323
PE
2950
FACILITY_ID
FA0023049
FACILITY_NAME
TELFER HIGHWAY TECHNOLOGIES
STREET_NUMBER
19256
Direction
N
STREET_NAME
STATE ROUTE 99
City
ACAMPO
Zip
95220
CURRENT_STATUS
01
SITE_LOCATION
19256 N HWY 99
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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lIK85 M Dnv orlWill,99503M08)'M60#RAX "782 _ <br /> ❑ 1455 McDawel d, Suite D • Petaluma, CA 94954+ (707)792-1865 • FAX (70742 <br /> QUOIA ANALYTICAL ❑ Striker Ave suite 8 + Sacramento CA 95834+ 916 921-9600 • FAX 916 921-0100 <br /> s19 ( ) ( ) <br /> CHAIN OF CUSTODY ❑ 1551 Industrial Road + San Carlos, CA 94070 • (650)232-9600 • FAX (650)232-9612 <br /> ❑ 404 N Wiget Lane • Walnut Creek, CA 94598 • (925) 988-9600 • FAX (925) 988-9673 <br /> Company Name Project <br /> Mailing Address Billing Address (if different) <br /> City State Zip Code <br /> Telephone Fax# PO # <br /> Report To E-mail Address QC Data ❑ Level II (standard) ❑ Level III ❑ Level IV <br /> Sampler Date 1 Time Results Required Sequoia's Work Order# <br /> Turnaround ❑ 10-15 Working Days ❑ 72 Hours MANDATORY ANALYSES REQUESTED Please Drovide method <br /> Time (Standard TAT) ❑ 48 Hours ❑ SDWA(Drinking Water) <br /> ❑ 7 Working Days ❑ 24 Hours ❑ CWA(Waste Water) <br /> ❑ 5 Worlang Days ❑ 2-8 Hours ❑ RCRA(Hazardous-Waste <br /> ❑ Other <br /> Client Date 1 Time Matrix #of Container Sequoia s 1 , Comments/ <br /> Sample 1 D Sampled Desc Cont x6e e`Sam le# Temp(if required <br /> 2 ✓ / r � <br /> 3 ✓ _ ; <br /> 4 Ij f <br /> _ 1 I <br /> 7 <br /> 9 614A <br /> 10 <br /> Relinquished By eceived By. �.� Date 1 Time <br /> Relinquished By Recei ed-By� Date/Time <br /> Relinquished By Received By Date I Time <br /> Relinquished By Received By Date I Time <br /> Were Samples Received in Good Condition? ❑ Yes ❑ No Samples on Ice? ❑ Yes ❑ No Method of Shipment z Page of <br /> White Sequoia Yellow Sequoia Pink.Client <br />
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