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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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ZUCKERMAN
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2900 - Site Mitigation Program
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PR0505863
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COMPLIANCE INFO
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Last modified
9/11/2020 2:28:20 PM
Creation date
5/1/2020 10:39:13 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0505863
PE
2953
FACILITY_ID
FA0007058
FACILITY_NAME
MCDONALD ISLAND DUMP SITE
STREET_NUMBER
111
STREET_NAME
ZUCKERMAN
STREET_TYPE
RD
City
STOCKTON
Zip
95206
APN
12908071
CURRENT_STATUS
01
SITE_LOCATION
111 ZUCKERMAN RD
P_LOCATION
01
QC Status
Approved
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EHD - Public
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=_�_—=�= En�ironmen/arotessiona/s <br /> a ChAiN OI- CUSTODY RED le 00 IC I Audit Services , Inc . <br /> Date 6- 10-q <br /> Page �_ <br /> now1BOJ Wast March Lana, Suite A- Stockton, California -95207 (209)95G 02GA of- <br /> 95207 <br /> ClientFq CO� ro f� � v � T owl S� . P havq Project Manager �� � Z AS Gy <br /> K p v;J M ('K; 6G o Tests Required <br /> P b. �0X j S 7 Phone Number <br /> 57OCK) eh I CA gyza I (x.09) q56- 0z6y <br /> Project Name M c <br /> Samplers: (Signature) � <br /> p <br /> 1. I nvc <br /> ov�e�c� S�Qh� GeoAu <br /> Clic <br /> Sample Location Sample Type (� <br /> Number Description Date Time Water Solid No. of �� ��•�v N <br /> comp. —cfab:- Air Conts. /� <br /> P _ 11C.-II.,04 w I <br /> X982 P—i7��o�g�, p <br /> 15:SO x I pr y <br /> �x M 16 : ;a X Coy of;r* 2, 1 <br /> _ ,1-- E X <br /> le <br /> rg�u,.) <br /> I w� ,i n lure 1'nquishod by: (Sig <br /> Ile oivod by: (Signoluro) -ref'4 <br /> Dale/Tim <br /> Ile linquished by: (Signature) <br /> flocoivod by Mobilo Laborolory for liold analysis: (Signature) <br /> Dale(Tlm <br /> Dispatched by: (Signature) <br /> Date/Time Iloceived for Laboralor h <br /> Y Y� <br /> Method of Shipment: Dele/Tlm <br /> U�i�r N .�lo nT(ICn Laboratory Name <br /> Special Instructions: ' r 1Ca41b <br /> GOOD MOON, PPROPEIATE <br /> I hereby authorize the Performance of the above Indicated <br />
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