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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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4400 - Solid Waste Program
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PR0440005
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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
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SJGOV\cfield
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EHD - Public
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1-0-2719 Analytical <br /> ENVIRONMENTAL SCIENCES <br /> Chain of Custody and Cooler Receipt Form for 2317700 Page 2 of 2 <br /> FACEARALYTICAL CQQLFR REC P7 FORM Pae QF-_ <br /> �L1binjssion #: � _ <br /> SHIPPENG INFORMATION SHIgPI 0 C0NTAIHER FREE 000 <br /> Ped Ex Q UPS O {ASO I GLS C fund Dellv&ry 0 !ce C31aa#!, T vnl1 ❑ poi€ Q YE3 NO ❑ <br /> Pace Lab Meld Servlcl Other❑ Other 0{5pooifyL_ 1 <br /> Rafri Brant; Ire Mre Ice❑ NOAQ❑ Mer❑ Cpnsmellt5: <br /> 0uatady Doals Jse CFlest❑LaCoutainam❑ NOM E Cpm-nionLs, <br /> dd?Yoe L3Na Q ImlacL'2I- Q Ko ❑ <br /> AL1 aampdas rczeEve154 YeAk Nap All samples containers Inlaec? Ycs Wl Peecdptlan(a)rrLPWh 4;0C? Y a CJ <br /> OG Received Emisxniy 6, � con131nor lilsrnamWorLD'. '1`� D:1WTlrW%M 7 i <br /> YE5 El NO Teraporah=- {A) - *C J C } *c Atlal�tas rIrl+- <br /> SMIPLLNLJUDEBS <br /> EAPAPLE CIDNIANER5 <br /> L ] 71 1113.FE U14rR93 <br /> 4 yn <br /> I <br /> xC <br /> T IM uEn3rCAL METALS — <br /> LNORlGhNICC FASChI.METALS 4u2 faoEl Mai - - <br /> 3aF — <br /> L`T PUTROCEN FORMS .. <br /> FT TOThL SUL nE — <br /> i[iPIT.PATF.f NlYl 377 <br /> TTT4rAL6aGh RAON <br /> �r Vr1e 3 ViYG I <br /> 4aia VOA VIA YFLL,LAIILC <br /> 40.JY12h VIAL <br /> 7 EF,L 1IGt[S <br /> Px A <br /> RIUTA[36tAL <br /> �OniIV VWi.i4i <br /> T FPA 501MOLM141A I I <br /> QY'SFxiil4lJEIS1A <br /> FPA SY5.2 <br /> EPAEl3.2TRAV&L +LNIL <br /> 4NIm1 EPA 03-I <br /> M V?X 34M <br /> 1'FPA 549.2 ._. . <br /> Wr E 3-W <br /> OT LSF] <br /> Som IOWOZo6 hM®6R <br /> ear 111em r b3uF i,�R <br /> i LeeuE <br /> FCR VIA I. r <br /> FLShTIC LAG _ <br /> ,rltor.AR BAG <br /> L'$ <br /> ENLVR2 <br /> SUMMA CANISTER <br /> Camrnaais; <br /> sLample Mmhprinq CcmPrcWElr. DaEcRinm, Oigw fl—21asnam <br /> A=Astual I G=G9rrud1W aI <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: 1001461329 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.pacelabs.com Page 6 of 18 <br />
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