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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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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
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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 2317662 Page 2 of 2 <br /> PACE ANALYnCAL COOLERRE�CEIPTPORM Page pfd <br /> Sularrrissiaro#: <br /> SHIPPING IN50RMA710H SHIPP C CONTAINER FRIQUID <br /> Fed Ex ❑ UPS❑ oSQ f OLS Q Hand tell ry ❑ rca ChBsw [done 1-1 Bax ❑ YE$ Ppb ❑ <br /> Pato Lab HOW$oMue I otbor❑(Speclfy)_ Other ❑(Spe'clfy) <br /> Refrigerant. Ise Srue Ice Q None 0 OtherO Comments: <br /> CuafodySeale IceOhek 0pnt9igem8n None Comments: <br /> :1ZIIel7Yes D Woo beta?? `ea D Gla E <br /> Allsarnp[es recplwd? Yevg NOD All aemplm ccnlelnera Intact? YesLINo Q descrrplran�a}makh COC? Yes No Q <br /> ,COC Received TEmEtal,%Yt p~ conr naa ,Thormorner r 14= naeerrlme�2 <br /> Qt YES 0 No Tenumrature: I A} 1L,112100 <br /> BPAIPLE=NureieERa <br /> SAMPLE CONTAINERS <br /> 'I'B L4V L'RFS <br /> �lasigExitso¢TI&Ut+eR6S <br /> Sat Cf` <br /> TIN rtr,LNI iHRW PT,LIS <br /> INOWIANIP A f 60;116DZ <br /> E <br /> r <br /> NETAf]I. FY5RM17S <br /> ALS11LlEa6 <br /> 2—MTRATiF.XNrrFZrTF <br /> PT A 0-rlffl CARE DLN <br /> FT CE{Gdi] A[. 1L'Yi:F.N nP. <br /> r I <br /> V V I{ <br /> OT}:8A HAB <br /> PTOCOtt <br /> J <br /> 'SnUN <br /> RA`i`6FUOLC1OWAI. <br /> T EPA SD3fDJ.]laee[ <br /> Qt L%a1aJhU1A <br /> QIP rr <br /> EsTA 453 r VF3 <br /> l4s�d hPA E3i.] <br /> �:EPk 546 <br /> T EPk S0.7 <br /> E2PA 827[1[ <br /> 8m;E6tZIMaz AUVEiR <br /> [&:l}2vcl i <br /> SUIL SLYEfV ' <br /> rusrlca�,c <br /> TRINAR ekr: <br /> #] n <br /> ENMRP. <br /> SMART[OL <br /> 51JUMA-CiNMEA <br /> �9iOnLPISLB:'� fl ��f �•5 <br /> SornpLeNumbe31Rt1OnompleEed9y' L41121batefrime: ReyE3arW21 <br /> A=Aetaal I C a i'anealetl ' Ls1+ro:rmtoan�rt:a:.ucpv:�ronvHewnocre.al <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: 1001456612 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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