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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 ANALYTICAL, INC. CHAIN OF CUSTODY RECORD <br /> int WILLOW PASS ROAD TURN AROUND TIME ❑ ❑ ❑ ❑ <br /> ARG,C.1 9iSG5 1741 <br /> �►�r+��►� <br /> I Website: .mamAmptm�l.cynk Email: main*mccamphtll.cam Rf'tiEi 24 NR 49IIR 72 HR 5 DAY <br /> Telephone: (977)252-11262 Fax: (925)252-9269 CcoTraeker EDF ❑ PDF 0 Excel ❑ Write On (T)W) ❑ <br /> U Check if sample is effluent and "J" na , is required <br /> Re port To. Bryan Cam p bell Bill To; AEI Consultants Analysis Request Other Cern ments <br /> Com pany: AET Consultants 25110 Camino Diablo, Walnut Creek.CA 94597 =�Indicate <br /> here if these <br /> E-Mail: begin bell neiconsulfunts.com <br /> samples are <br /> Tele: 92$ 74&6044 Pay., 925 746-60" potentially. <br /> Project#: 303662 PO WC083517 Project Name: ply&5 _ z I dangerous to <br /> Project Location; 678 No rtkWilsqWWV,5to Eton California D handle.- <br /> Sarn Irr Sig nature: <br /> SAMPLING MATRIX ►ESERVD <br /> ` PRSF.R1 F:I! U z <br /> LOCATIGM o aC <br /> AMPLE [D p <br /> Field Poin7 _ ca <br /> i Name Date Time e C L I L- k- _ P <br /> ki <br /> ak F sii ux <br /> "'NIAl clients MI.IST disrlw qny cIlnkrrnus chcmicalz known to he preseni in timir suhmiited sarnrlcs in rain nrrmions timi Indy ea use immediate harm or serious future health ends ngermcnt as x rezult 13f Kriel, <br /> glowed,open Hir,sample handling by II,U staff.tine-di.ulosure incurs an immrdialc 5254)zurrharec and thr rIient iz Nuhjret to fuII Icgal limhiIiiy for harm suffered. Thank you for your understanding sed for <br /> Alhrn i ng us to work safely. <br /> Relin a Dale- TIME. s' ICF1N U0MI4ENTS- <br /> ,0 GOOD CON D[TIaN <br /> IIEADiPACF.A RSENr <br /> Rellnqulsltrd By: Dale; Time: Receilotd BY: DECHLORINATED IN LAB <br /> APPROPRIATE CONTAINF,R <br /> PRESERVED IN LAS <br /> Rclinqukhsd Fly- Date: 11mr_ Received By. <br /> VOAS MG METAL'; OTHER <br /> PRESERVATION 01<z <br /> Page 4 of 19 <br />
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