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SR0082876 (4)
Environmental Health - Public
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4300 - Water Well Program
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SR0082876 (4)
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Entry Properties
Last modified
10/19/2022 2:50:59 PM
Creation date
10/19/2022 2:06:02 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
WORK PLANS
RECORD_ID
SR0082876
PE
2903
FACILITY_ID
FA0026235
FACILITY_NAME
RAISING CANES RESTAURANTS LLC
STREET_NUMBER
4707
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
10816004
ENTERED_DATE
11/12/2020 12:00:00 AM
SITE_LOCATION
4707 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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I 885 Jarvis Drive * Morgan Hill. CA 95037 • (408) 776.HOU • FAX (4v#) fV-k ddb <br /> V i '� :: L:j 819 Striker Ave., Smite 8 ■ Sacrarrrente, CA 95834 • (916) 921-9600 - FAX (9 16) 92-1-0100 <br /> Q 404 N. Wiget Lane • Walnut Creek, CA 9459B , (925) 988J-9600 F FAX (925) M-9673 <br /> OSCO <br /> §d 1455 McDowell Blvd. North, Suite 1) • Petaluma, A 94954 • (707) 792-1965 • FAX (707) 7$2-0342 <br /> Q 1551 Industrial Road - San Carlos, CA 94070 • (650) 3 WO0 + FAX (650) 23 9B12 <br /> onsuflant <br /> ompaly: -w, ���� lL`'�. Tasca Engineer: <br /> Address: ,} J �i µ — - ', Site : <br /> Gil stale, ''f� 7-i p CvdF.-- C'r � Site Address: 707 <br /> Tr le h In w _ Fax #: f ' iCy, State; C <br /> Repos: To- ot Sa�er ' - �*` r` OC Data, ElLevel D (Standard) Ll Level C1 Level 9 Q Level A P <br /> c <br /> iljrnaround :j lU Werk Gays 5 bWotk Days ;-1 3 Walk aiys -i Unilkicu)Walur Analyses Requested 11 <br /> Mme: j 2 Waris Days ;a 1 work Clay ,j 2'a Hours ❑ W'5!ite WaleF <br /> PiojeclCoding: <br /> Client DatefTime mall �� t]f Cont.' — Sequoia's i <br /> Scrapie I.D. Sampled � Ulm cont, Type Sample N �`�� � �'� � �s�,,' {�� Culzll��cr�ls <br /> i r � <br /> 4. <br /> S- JULER Lr 1)Y SEAL$ IN ACT <br /> 7. *1ir <br /> ;:C!el <br /> 49. <br /> -- — — — -- �- --- — I - — <br /> 1Q. <br /> Relinquished By 1L batt=: Tlme: _ R1_ e1Vpd <br /> Relinquished By —�. Bale; �- Tirne: Received r3 � Eula- Time: <br /> Relinquished [}ste: Time: Received Hate: Time: <br /> Were S&mples Received ire Good Condition? a Yes ❑ No Samples on Ice's 0 Yes 0 No Method of shipment _ Page of <br /> TO be earnpleled upon reCeipt 101r9prA: <br /> 1)Were 11116 analyses requested on the Chain of Custody r"rted? [D Yes ❑ Nin If no, what antilyses are soil needed? <br /> 2)Was the report issued within the regi mted turnaround lime? ❑ Yes ❑No Ir no,what was 11)e turnaround lime? <br /> Approvdd W. Slgnaiure: — Company; Dale= <br />
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