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ARCHIVED REPORTS_XR0005610
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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14800
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3500 - Local Oversight Program
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PR0545626
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ARCHIVED REPORTS_XR0005610
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Entry Properties
Last modified
11/19/2024 1:50:29 PM
Creation date
4/29/2020 1:42:36 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005610
RECORD_ID
PR0545626
PE
3528
FACILITY_ID
FA0000957
FACILITY_NAME
LATHROP GAS & FOOD MART*
STREET_NUMBER
14800
Direction
S
STREET_NAME
STATE ROUTE 99
STREET_TYPE
RD
City
MANTECA
Zip
95336
APN
19702004
CURRENT_STATUS
02
SITE_LOCATION
14800 S HWY 99 RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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Phone(916)2110 St nd restos to <br /> F :x (916)786-7930 AEGIS Environmental Consultants, Inc. Acgis iNnvironnicnial ' <br /> tp5p Meltxl 1<,ane,Suite 160 <br /> Sample Identification/Field Chain of Custody Record �d"nelle,rn tc 160 <br /> 678 <br /> hor Shell Projccl5 Only <br /> Site Address A400 -,- D 111en WIC <br /> AEGIS Protect 0 02-() 7 - AFE <br /> Co <br /> Shipped By CT/DL <br /> Shipped To A) ^ Shell Engineer <br /> Protect Manager 6rlqQ Hazardous Materials Suspected? (yes/no) <br /> Sampling Sample No of Analysis <br /> Point Location Meld lD# Dale 7 ypr Contac tern Required <br /> `Qf <br /> 9-SGS t ( A o v _MW- 2y ' -��-yl <br /> s <br /> eI r�x Z2 <br /> BS 700 ? -MO)J -YOS' SOIL <br /> fin M �� _Sc� S r/l14 7--SPl- 9 SOIL- 2 <br /> Sampler(s)(signature) , <br /> Field ID Rehnquished 1 y(signature) 115teived By(signature) Datd I line Comments <br /> Scaled for shipment by (signature) Datell uric Shipment Method /I <br /> Received for Lab byr (Signature) moi- ��- Date/l uric ��� ii o�Z!i, ComnienLs -- �� 6P(Gu1 -siz,- re <br /> 1 L U �e 1l <br /> Receiving Laboratory Please return original lorni alter signing for WLCIpt of samples <br /> Whin/(A11 ind YCHOW/1 Lh(iq)y I'mkil ile 04)y <br />
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