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ARCHIVED REPORTS_XR0006835
Environmental Health - Public
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EHD Program Facility Records by Street Name
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Y
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YOSEMITE
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420
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2900 - Site Mitigation Program
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PR0537485
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ARCHIVED REPORTS_XR0006835
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Entry Properties
Last modified
7/27/2020 5:36:27 PM
Creation date
7/27/2020 3:35:07 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006835
RECORD_ID
PR0537485
PE
2957
FACILITY_ID
FA0021568
FACILITY_NAME
FORMER RAINWATER CAR WASH
STREET_NUMBER
420
Direction
W
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
APN
21931206
CURRENT_STATUS
01
SITE_LOCATION
420 W YOSEMITE AVE
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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LSauers
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EHD - Public
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I <br /> Nam m m m m m m <br /> _ i <br /> CASTLE ANALYTICAL LABORATORY 7 CHAIN OF CUSTODY <br /> Location 2333 Shuttle Drive Bldg 9081909, Atwater, CA 95301 Certificate No 2079 <br /> Mai4tng Address 2333 Shuttle drive Atwater, CA 95301 PAGE-OF- <br /> Phone (209) 384 2930 Fax (209► 384 1507 <br /> I i <br /> I Customervo d rp ) �r) REQUESTED ANALYSES Method of Shipment <br /> Address _ (}p ' <br /> City/State/71P 1 m d CA- lherl)! <br /> LU <br /> Phone FAX _ 9 a s ¢ �`rtes <br /> Pro) # , P 0 # w s i w WmC'J S�jjj.7 rhk Si- <br /> Report Attention a 6 = ' LL araC jtfsf� D�j <br /> � � IL G <br /> Sampler Signature u E a m 11.1 1)64 [b24r)oj <br /> Printed u �, VO � c{np -P <br /> z �k <br /> Lab ID# SAMPLE ID DATE TIME DESCRIPTION/LOCATION �NSJf;EAAARK5 <br /> 0 94 — , b 56926 <br /> 5A <br /> r <br /> 8--Z <br /> Zi 56927 <br /> 55928 <br /> I <br /> 56929 <br /> 56930 <br /> I <br /> Signature Printed Name fate Time Company Name Total number of laboratory submitted to <br /> t� P Y the laboratory <br /> Ir <br /> d by « f L# �� rL r y Z- 6Ta� `L • Note All special requests(e g quick <br /> y _ a turn times)must be cleared through <br /> q7 <br /> d byauthorized laboratory personnel <br /> yd byU�� I{�TL� LU RESULTS DUE <br /> �r i "', 1' <br /> VERBAL WRITTEN <br />
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