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ARCHIVED REPORTS_XR0009358
Environmental Health - Public
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EHD Program Facility Records by Street Name
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12TH
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2900 - Site Mitigation Program
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PR0518209
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ARCHIVED REPORTS_XR0009358
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Entry Properties
Last modified
5/8/2020 2:44:38 PM
Creation date
5/8/2020 2:29:39 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0009358
RECORD_ID
PR0518209
PE
2950
FACILITY_ID
FA0013759
FACILITY_NAME
PACIFIC BELL
STREET_NUMBER
10
Direction
E
STREET_NAME
12TH
STREET_TYPE
ST
City
TRACY
Zip
95376
APN
23336922
CURRENT_STATUS
02
SITE_LOCATION
10 E 12TH ST
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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LSauers
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EHD - Public
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M"�-3a' M "W MIT ' Cf WOOM Lam► rAMIS M M117 F J� 0-0 <br /> Sl'-vv Env mental& Infrastructure, Inc G�j Purchase Order <br /> 1326 North Market Blvd Sacramento, Calif 95834 ' r/ Lab Mc Cambell <br /> Project Name SBC,Tracy Ground Water Sampling Anal sis Requested <br /> Protect Number 83881918000 <br /> Project Manager Sydney Geels/Rob Delnagro <br /> Conipany Shaw Environmental& Infrastructure, tic <br /> Address 4005 Port Chicago Highway c <br /> Concord,Ca 94520-1120 <br /> Ph 925-288-2103 1 Fx 5- 27 0 <br /> O p N p <br /> 0000 <br /> Sampler's Signature <br /> z C 17- REMARKS <br /> Sample LAS Sample VOAs Liter GIs Container Types <br /> I D Date Time I D Matrix HCI NP Preservations <br /> -� MW-1 41/09 Water 4 3 1 <br /> MW-2 f Water 4 3 1 <br /> MW-3 Water 4 3 I <br /> I <br /> i <br /> i <br /> RELIN HED BY R RELINQUISHED BY RECEIVED BY TURNAROUND REPORT REQUIREMENTS <br /> / / <br /> REQUIREMENTS X E Routine Report <br /> re VL'9L?C&-1ez5 <br /> Signature Signature 24 hr 48 hr 5 day II Report(includesG�urem� X Standard(-10 15 working days) MSD,as required,may be <br /> Pr �,dName Pr Nyfk,. <br /> Printed Name Printed Name Provide Verbal Prerimtnary Results charged as samples) <br /> Pro%ide FAX Preliminary Results III Data Validation Report <br /> FtF��p� L,/� Firm Finn Requested Report Date (includes All Raw Data) <br /> r� <br /> r, /e= 1 RWQCB <br /> Date,Tlme I nftIIQU4�Date/Time Date/Time Date/Time (MDLs/PQLs/TRACD) <br /> RELINQUISH DB RECEIVED BY Special Instructioq�yrime t �f Container Types Key <br /> GOOD CONDITTOIE :_ _ APPROPRIA I McCambell Analytical 40 ml VOA I <br /> Sign,fture Signature HEAD SPACE ABSER CONTAIMBIl.4r..,.... l 10 Second Ave,South, D7 250 ml LPI; 2 <br /> EDF REQUIR&LORINIATEDIN LAI; MERVEIDIN heco,Ca 94553 500 ml LYE 3 <br /> neba r�rai� atr!>i� <br /> Print,,d Name Printed Name PRESERVATION 925-798-1620 1 liter HDPE 4 <br /> Ed Hamilton 500 ml glass 5 <br /> Firm Firm I liter glass F <br /> Ship samples overnight via Fed X using acct N 151298893 2x6 s/s ring 7 <br /> Date Time Datel`I'1meglass�ar 8 <br /> RECD SEALED b INTACT'VIA��'K <br />
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