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2900 - Site Mitigation Program
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PR0542431
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Last modified
5/4/2020 4:08:39 PM
Creation date
5/4/2020 3:35:21 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0542431
PE
2960
FACILITY_ID
FA0024384
FACILITY_NAME
PORT OF STOCKTON CARGILL PROP
STREET_NUMBER
0
STREET_NAME
PORT
STREET_TYPE
RD
City
STOCKTON
Zip
95203
APN
14503012
CURRENT_STATUS
01
SITE_LOCATION
PORT RD 21
QC Status
Approved
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EHD - Public
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INTERNATIONAL <br /> TECHNOLOGY <br /> CORPORATION REQUEST FOR ANALYSIS R/A Control No. 276147 <br /> PROJECT NAME GAr2.Glty C/C Control No. <br /> DATE SAMPLES SHIPPED �Ea_ 1 t- <br /> PROJECT NUMBER I9 -7 - �1 <br /> I <br /> LAB DESTINATION _�c.E L14lyg NOYAtT1p <br /> PROFIT CENTER NUMBER 1 LABORATORY CONTACT CR2oN S�ftM►� <br /> PROJECT MANAGER Tl✓I AW�pN -- <br /> BILL TOSEND LAB REPORT TO - CORP <br /> T n�r.�- .2A�-10►1 <br /> "40t ilIOEz _ MA2f7r,>EZ� C4 `I45r <br /> CA 9��-C�3 DATE REPORT REQUIRED <br /> PURCHASE ORDER NO. PROJECT CONTACT T, <br /> AutE*zoN 0i¢ err <br /> PROJECT CONTACT PHONE NO. S10) 877-91010 <br /> Sample No. Sample Type Sample Volume Preservative -- ___ 4 <br /> Requested Testing Program Special Instructions <br /> (.2y11S Mlax- �oI 2'Kre" ��srusE coot_ 4°C_ <br /> q1, _ �a Rast,us <br /> L 4- Ji �. A.16.131p <br /> TURNAROUND TIME REQUIRED: <br /> Normal (Rush must be approved by the laboratory Project Manager.) OC LEVEL: (Levels II and III subject to surcharge;project-specific requirements must be <br /> Rush ✓ (Subject to rush surcharge.) I submitted to lab before beginning work.) <br /> III Project Specific <br /> POSSIBLE HAZARD IDENTIFICATION: (Please indicate if sample11s)are hazardous materials and/or suspected to <br /> Non-hazard �� Flammable contain high levels of hazardous substances.) <br /> Skin Irritant <br /> SAMPLE DISPOSAL: Highly Toxic <br /> Other <br /> (Please indicate disposition of sample following analysis. Lab will charge for packing,shipping,archive and disposal.) (Please Specify) <br /> Return to client Disposal by Lab / <br /> Archive____ (Indicate number of months.) <br /> FOR LAB USE ONLY .—___- .__..-__. __ <br /> Received by vIL Ekr Date/Time_-_�-�I1.V�ri/ __ <br /> WHITE-Original,to accompany samples `7 - <br /> YFI I()W-Fuld nnnv <br /> 126A 10-85 <br />
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