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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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T
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TRACY
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3081
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2900 - Site Mitigation Program
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PR0515030
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Last modified
5/8/2020 12:31:23 PM
Creation date
5/8/2020 11:55:16 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0515030
PE
2950
FACILITY_ID
FA0012018
FACILITY_NAME
QUALITY CLEANERS
STREET_NUMBER
3081
Direction
N
STREET_NAME
TRACY
STREET_TYPE
BLVD
City
TRACY
Zip
95376
CURRENT_STATUS
01
SITE_LOCATION
3081 N TRACY BLVD
P_DISTRICT
005
QC Status
Approved
Scanner
LSauers
Tags
EHD - Public
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SunStar Laboratories, Inc. Chain of Custody Record <br /> 25712 Commercentre Dr <br /> Lake Forest, CA 92630 <br /> 949-297-5020 r <br /> �d/ fnP� If <br /> Date: I�I�J /7 Page:--I�Of <br /> Client: 3aa S Al, Trtr �aI / 'tc <br /> Address �G� (}(`` aa� ae © Project Name: <br /> Phone: S�/�7a�' � t73 "� Fax: Collector: E E'a9leAowf _ClientProjectM 19—�aqY r. <br /> Project Manager. fon, CaT(nG j 1 Batch#: -rl"Ias EDF#: <br /> PCC a,,t Val hferj <br /> r" PLEA tCE� <br /> C C;$-Id-VCF,-.A5-P-a <br /> O N C <br /> Yj O <br /> N <br /> 4 0w m a W g <br /> + m <br /> Sample Container "' "� "� ao ` rvative o <br /> Sample ID Dat Sample Time Type Type m m m m m m 0 <br /> Comments/PreseF°- <br /> 1 0 ; ac F or b <br /> —IU 020 3 F IOL <br /> 1100 <br /> I 1-faL- <br /> 3-a 1000 x . <br /> o� )dOLO <br /> —S <br /> 09 <br /> i• to_ ifS W _ tl <br /> I I tz <br /> 1 . G <br /> Relinquished by:(signature) ate/Time Re Iv d :($I tore) Date/Tune Total#of containers Notes <br /> 1 'S /C 1000 / V Chain of Custody sea /NA <br /> RelinquishedX.(signature) Date/Time Received by: si ature) Data/Time Seals intac Y INA STD. TAT <br /> _ p Received good wriditioNcold Qo 6 <br /> Relinquished by:(signature) Uate/Time R ed by:(signature) Date/Time - <br /> Turn around time: - e <br /> Sample disposal Instrucitons: Disposal @$2.00 each Return to client _ Pickup _ _ <br /> COC 133090 <br />
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