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SITE HISTORY_CASE 2
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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PR0500097
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SITE HISTORY_CASE 2
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Last modified
7/23/2020 3:32:15 PM
Creation date
7/23/2020 3:27:57 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE HISTORY
FileName_PostFix
CASE 2
RECORD_ID
PR0500097
PE
2950
FACILITY_ID
FA0001329
FACILITY_NAME
PONTES QUICKI KLEEN CAR WASH
STREET_NUMBER
707
Direction
E
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
APN
22323013
CURRENT_STATUS
01
SITE_LOCATION
707 E YOSEMITE AVE
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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CHAIN-OF—CUSTODY RECORD <br /> .1<1roLzan DATE:2-�� ^� � PAGE ( OF <br /> KRAZAN & ASSOCIATES, INC. Comments: REQUESTED ANALYSES P.O. Number: <br /> 215 WEST DAKOTA AVENUE t i,, e coo 14 -_271 <br /> CLOVIS, CA 93612 p -n Mr6 _ o Ice Chest No.: <br /> (209) 348-2200 VOICET�c r ' <br /> (209) 348-2201 FAX v Laboratory: <br /> L <br /> o � <br /> A tre <br /> Project Name a Co Lab Quote No.: <br /> to tiora <br /> l fy ;Project No.; 499 03 Ua <br /> x.o az om <br /> d a ooaSampler NaReport • a L? <br /> N <br /> (Printed): �Sltl <br /> G m R� Attention: �' FT�j w d O y d T Method of ShipmenVDelivery r <br /> 2 `m d a @ N o W n N N <br /> -j6 L d <br /> Lab Sample Krazan Date Time E b E c�o f E c W z a ¢ ¢ QDJ <br /> 1D Sample No. Sampled Sampled Sample Description W o cra n 0 o in r z v m ta- w w Remarks <br /> VI-41 .a — I r- I iso S D �v r x X X <br /> 3 &Sx x <br /> y <br /> i-Z 6? <br /> y!3 / <br /> X <br /> —$ PL 1 X <br /> 1.< <br /> r 5.. 3 _,"._ t-� ; o Number containers <br /> S gnature=,w= u, Printecl,Naine Date Ttme Company Name suomrnea ro tam <br /> x .. z . <br /> ftelin uished b : �,.( G r` amp`" ry <br /> Turn Around Time <br /> Received b : am pm (Circle Choice) <br /> Reliri uished by: am pm 48 Hrs. <br /> Received by: am pm <br /> Relinquished by: kl/ FZ2 7 ampm 5 Days Days <br /> Received for Labaato ><ti .: t v:. ' rC:� J. .. 'Xllg:. X2'1 f4'/ 15 C.: Pm � 'z� As Contracted <br /> While-Lab Yellow-Project File Pnk-C.O.C. Binder W� COC4.VSD G-23-98 <br />
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