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ARCHIVED REPORTS_XR0006841
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_XR0006841
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Entry Properties
Last modified
7/27/2020 7:00:21 PM
Creation date
7/27/2020 3:38:31 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006841
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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EHD - Public
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( <br /> CHAIN OF CUSTODY*CORD <br /> Advanced <br /> ---= , GeoEnvironmental, Inc. Date_O f Z L-41 Z page J— of � <br /> 837 Shaw Road- Stockton, California-95215-(209)4137-1006-Fax (209)14 -1118 <br /> Client in w t r Coote, W poo protect Manager Tests Required <br /> -Tr Cv£11 <br /> Phone Number 4 <br /> (2!,o5) O Q ti A p <br /> Samplers (Signature) ' b�� ti irwolce. <br /> Project Name It W <br /> �! /� !/ �f � '4 P CliAGEent <br /> Cv w L <br /> Sample Location Sample Type No of <br /> Ti <br /> Date me water Solid k �' Notes <br /> !Number Description Comp arae Air Coats <br /> lie NmP , �qte.� Tn��eA4 o Y cis T 58615 I <br /> XX <br /> 88616 <br /> I i <br /> Dari '!&G L'fT,i S' AH-C- <br /> �rCl~►n 5� c�nas�r�T a�JTAl�IE <br /> Relinquished y rgnatura Received y (Signature) _ oat, <br /> Pg Ko - 21 o 2- <br /> Relinquished <br /> - <br /> ei nqu shed by ( !gnature) Received by (Signature) Dateirnme <br /> elinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) DateMme Received for Laboratory by Date/Time <br /> Method of Shipment Labors ry Name <br /> C <br /> Special instructions 1 hereby authorize the performance of the above Indicated work <br /> fill 61�J L 1�n C. IL <br /> N b <br />
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