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ARCHIVED REPORTS_XR0009360
Environmental Health - Public
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EHD Program Facility Records by Street Name
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T
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12TH
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10
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2900 - Site Mitigation Program
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PR0518209
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ARCHIVED REPORTS_XR0009360
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Entry Properties
Last modified
5/8/2020 2:47:24 PM
Creation date
5/8/2020 2:30:27 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0009360
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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MM-NAMALMaMANALY-S #EM"rMB1 R nccntNo.OLOGY <br /> s4c > YoRA CHAIN CF CU <br /> RECORD Page I of t <br /> Project Name/No1 1 -�,, Samples Shipment Date gill to5 ��W&AJO�Cc��P m <br /> Sample Team Members 2 �- pn - Lab destination 8 t.. A - .� N <br /> 0 <br /> Profit Center No Lab Contact 9la A90;,C7Cnm <br /> R <br /> Project Managers 54wai S Project Contact/Phone 12 port to .. <br /> Re 10 M <br /> Purchase Order Na Carrier/Waybill No. 13 <br /> Required Report Date i 1 M <br /> 1 • !t • • 3 <br /> a' <br /> sample, <br /> 14 pe sample 15 Daaft/Time i cgntskwe emple1 Pia 19 Nqu=wW teedq 20 Canditlofl on 21 Gjepasul 22 � o <br /> Yol WOi'llMe SerwatYe M 1'i117 Record No. Cr <br /> 0 <br /> mc <br /> Z •-p ,D J- PUN Li <br /> U0 C U if <br /> Q <br /> D <br /> r <br /> CC <br /> Ct <br /> r <br /> R <br /> MAW � <br /> U) <br /> H <br /> Cr <br /> n <br /> Special Instructaans 23 <br /> � <br /> EP Y Possible Hazard Identification 24 Ln <br /> Disposal 25 <br /> Non-hazard Ffammebfe Skin Irritant CA Poison B Unknown Return to Client EJ Disposal by La E - Archive_ `1 <br /> Turnaro d Time Requir 26 QC Level 2 imps ] m <br /> Normal Flush I J it ill�j Pro ect Spec ( ec ] <br /> 7 Relinquished by 280 Oahe �,2 <br /> _ 1 Received by 28 Date 7 ro <br /> 2 Time. iG+s-ture/af�rret,nnl Aa Time,' S ry <br /> Relinquished by pate <br /> ( 2 Received by Date' m <br /> Time (�snaare�AffiiianonlY Time <br /> 3. Relinquished by Date 3 Recenred b <br /> (S�gnatw�/Arfiiietinni <br /> Time (�snRecerfriiiatlo by Dice <br /> Time <br /> Comments 29 <br /> N <br /> r <br />
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