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Environmental Health - Public
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0536935
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Last modified
7/7/2020 9:27:02 AM
Creation date
7/7/2020 9:24:01 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0536935
PE
2950
FACILITY_ID
FA0021203
FACILITY_NAME
VACANT-FRMLY HOLLYWOOD VIDEO
STREET_NUMBER
678
Direction
N
STREET_NAME
WILSON
STREET_TYPE
WAY
City
STOCKTON
Zip
95205
APN
14129014
CURRENT_STATUS
01
SITE_LOCATION
678 N WILSON WAY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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McCAMPBELL ANALY'T`ICAL, INC. CHAIN OF CUSTODY RECORD <br /> D <br /> I534 WILLOW PAS%9ROAD � rte- TURN AROUND TIME ❑ ❑ ❑ ❑ � <br /> Pl17SRl'RC:+CA 7461.1701 <br /> Website: ww��.mscamabelle%m Email: m*in�e?Rpccaropl�rll.coud R�1511 �41�R dR lilt 72118 5 DAY <br /> Telephone: ( -TnV 252-9262 Fax: 925}252-9269 GeoTracker EDF ❑ PDF 0 Excel ❑ Write On (DW} ❑ <br /> ❑ Check if sample is effluent and "J" f1fliz is required <br /> Report To: Bryan Campbell 131.11 To:AE[Consultants Analysis Request Other Comments <br /> Com pany: AEI Consultants 2500 Camintk Diable,Walnut Creek CA 94597 <br /> "indicate <br /> here if these <br /> E-Mail: bcamn hellzaeicansuItan ts.com I I% I i samples are <br /> Tele: 925 746-6044 Fax: 925 746-6099 � ! potentially <br /> Prii'ect 4: 305662 PO WC083517 Ppject Name: OR&S dangerous to <br /> Project Location: 678 I7SAMPL <br /> y, toe Mark,California 9 I handle: <br /> Sampler Si natuMETHOD <br /> re: <br /> SAMPLING MATRIX PRESERVED <br /> � z <br /> IAWATIONI <br /> SAMPLE ID Field E r <br /> NaThnt 5. b. D P <br /> V� <br /> at F rfi 5i C ` O <br /> S /7 t ff 10/6 1 <br /> 1 <br /> 1737 r s` <br /> **31AI elients SII 5T dimlow amy dangerous ehemicgLis kncnwn to lx present in their submitted ssmp1m in coneenirs lions that map cause immediate harm or serious future hesilh endiwrmvnr as a resulI i i f iprief, <br /> ` oved,o n air,sam ie handiin MAI staff.Non-disclosure incurs an imrnediate�2S0 surcha eand me clicnti%swF.?eettofull le al liability far hnrm suffered. Thank u for onrunder%mndin and for <br /> � � PC P �by- � J � t5' you J' � <br /> 2114»inp�us to work safely. <br /> Rriin Dice: Time: R y: rcut- t UOMMEWS: <br /> r GI l :oca~u c•oNll <br /> HFAII S tt"F'E A.tIN li�F"1"I' <br /> Relinquished Iia: Date: Time: Received By- DF.(tI1.RI R['�.il F:1) 1N [.\1# <br /> APP ROPRIr{kn Coo r.4 r1 F:1tL� <br /> PRF-SERVFD IN tAB <br /> Rrlinquishrd lis- Daft: Timr, Remised BV: <br /> VOAS O&G METALS OTrr£>a <br /> PRIFSERVATION PE11<2 <br /> Page 2 of 19 <br />
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