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COMPLIANCE INFO_2023 DOMESTIC WELL SAMPLING
Environmental Health - Public
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EHD Program Facility Records by Street Name
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A
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AUSTIN
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9999
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4400 - Solid Waste Program
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PR0440005
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2023-2026 Reports
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COMPLIANCE INFO_2023 DOMESTIC WELL SAMPLING
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Entry Properties
Last modified
11/14/2023 4:26:31 AM
Creation date
11/13/2023 2:13:14 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4400 - Solid Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023 DOMESTIC WELL SAMPLING
RECORD_ID
PR0440005
PE
4433
FACILITY_ID
FA0004516
FACILITY_NAME
FORWARD DISPOSAL SITE
STREET_NUMBER
9999
STREET_NAME
AUSTIN
STREET_TYPE
RD
City
MANTECA
Zip
95336
APN
20106001-3, 5
CURRENT_STATUS
01
SITE_LOCATION
9999 AUSTIN RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\cfield
Tags
EHD - Public
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1-0-2719 Al tr # <br /> ENVIRONMENTAL SCIENCES <br /> Chain of Custody and Cooler Receipt Form for 2318058 Page 2 of 2 <br /> PAGE ANALYTICAL CQQ;ER RECEIPT FORM Pa c Of <br /> Sul�mission�; ���r <br /> SNIPPING INFORMATION S141PPING CONTAINER FREE IQIIID <br /> E7[ <br /> Fed ❑ UPS❑ G5o t GLS❑ Hand Delivery Cl1oe che!a None Cl Box fa Y NO a <br /> Paee Lab FLeld Service DthEIF❑(Sgeel(Y} 0-mee ❑(SP007) <br /> Refrjgarant; Ice Blue loe 0 Ronc d Other❑ Comments: � <br /> Gusrody Seals Ice Chest 0 COFtl-iners fl planed COFFem nks: <br /> Imact2 YaR❑ No Irvinet?Ycs INC!❑ <br /> All Wrnplas t0ulvad7 Yoe V No O NI sdmplos conWrkors intact? Yes No a DesCr[Pilon�s}makrb COC? Vag No ❑ <br /> QC Received Emleam4" q* Covitalner. 1` Th8m5ormler ID; Daberrimo I ° <br /> I YES ❑ NO Tai"eeyature: IA} I 'C f (C L' "C An81y8llnL# <br /> i <br /> '.- <br /> SAMME aaLJWUFM <br /> SAMPLACONTALMERS <br /> f 3 7 i d c P # f 10 <br /> PP SIFtP0.E5 <br /> d p.t Ekkf Maz L'$lrNPR4a <br /> ANC{C11� ETALS ,_ <br /> IN4RLd 'HFAi1C4L MET l2G� <br /> KLNTPM <br /> aOh!M1lAi46 , <br /> eutif 105 <br /> -0a"v V TRa.VELEL.AK <br /> GamL VOA 4' <br /> OT EFA 12KE <br /> lyroDort <br /> Ah L <br /> loL6G7 <br /> -00 WQrk VIA[--MG <br /> 3 PASldrapl, <br /> QT EPA SiiJJLrSlA , <br /> F SLC2 <br /> QT <br /> YLL ELhr4JG <br /> a 34r <br /> Sae ETA Si$,[ .. <br /> 7 gP sa .x <br /> T ErA oomk <br /> 7 RPA E170C 5 <br /> Em <br /> 3 i1FF.&3N�.lAltVBACRAITANJnWv <br /> Sarnp[e Nutnderlug Camplo-tcd Bj: L aleJTlmP; r4.0 sos xa <br /> A=Atluel I C=CorreCiti3 Is:rmo.rrwN�ul "�.° rausxwncGA.3°I <br /> i <br /> The results in this report apply to the samples analyzed in accordance with the chain of custody document.This analytical report must be reproduced in its entirety. <br /> All results listed in this report are for the exclusive use of the submitting party. Pace Analytical assumes no responsibility for report alteration,separation,detachment or third party interpretation. <br /> Report ID: 1001458266 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.pacelabs.com Page 4 of 15 <br />
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