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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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WOODWARD
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9909
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2900 - Site Mitigation Program
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PR0508168
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Last modified
5/26/2021 1:00:21 PM
Creation date
5/26/2021 10:27:16 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0508168
PE
2950
FACILITY_ID
FA0007971
FACILITY_NAME
KARLSON TRUCKING (FORMER)
STREET_NUMBER
9909
Direction
E
STREET_NAME
WOODWARD
STREET_TYPE
AVE
City
MANTECA
Zip
95336
CURRENT_STATUS
01
SITE_LOCATION
9909 E WOODWARD AVE
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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Bill <br /> HAIN OF CUSTODY RECORD <br /> aherwood AL 8071 N. Lander Avenues C Q <br /> P.O. Box 93 <br /> Hilmar, California 95324 <br /> Labs (209) 667-5258 Attention P <br /> CORPORATION FAX (209) 667-2581 IFIL d7-A-3 Page of 1 <br /> Job Number P.O.M Project Name <br /> g\. 7— SSEiI. (v��DW Aft �� <br /> Samplers:(Signature) Site Addre <br /> '-LA"A L.I su,, 1 C,9N E•NUMBER TYPE <br /> SAMPLE LOCATION DATE TIME SAMPLE t�,• �v � .Z- <br /> (IDENTIFICATION) (WrWDAYNR) (HOURIMIN) OF (GRAB MATRIX Q� <br /> CONTAINERS COMPOSITIT � <br /> E) ' � � � REMARKS <br /> S 13-8 -11' 0 1T6/0D 1030 -'L C,-P,,ra d I So 1 l_... <br /> SC3-9 <br /> 15,3-10 <br /> SF3-lo t It>,f 11 123 i1 �I II OL1 � <br /> 'SL3-f0 19-Z1. 1� 3 1 II IH6W1 <br /> 58-10 ZA--L61 W 10 I I I lA <br /> a <br /> _3 a S/ <br /> Relinquished By:(Signature) DateTme ` Received By:(Signature) Date/Time <br /> 'I ,n, -71M <br /> ) TURNAROUND TIME <br /> �, -7M / 11 1 -Z7 00 <br /> Relin uished By:(Signature) DataMme i By:(Signature) DateMme 24 HOUR ❑ <br /> Ila 7/0 0 ` t/ 1 -� 00 1.33� 48 HOUR El(elinquished By:(Signature) Dateftime Received By: ignature) bateri ime 5 DAY <br /> DISTRIBUTION: Original-Accompanies Shipment Canary Copy:Sherwood Pink Copy:Sampler NOTE:Samples are discarded 30 days after results are reported unless other errangeffwvs are made. <br />
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