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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 Al tr # <br /> ENVIRONMENTAL SCIENCES <br /> Chain of Custody and Cooler Receipt Form for 2317665 Page 2 of 2 <br /> FACk,gpa,gMMAL UGGLER RFGEI PT FoRhA <br /> suhmNsion#: Yl WP <br /> 5H]PP3NG INFORMA71ON 5HIPP NG CONTAINrfK FRES ICtLIID <br /> Fed Ex G UPS ID G30 f G1-S O Hand 17cllvo ry ❑ Ice Ghesfo Nuft ❑ Sex Ci YENO ❑ <br /> Race Lab Field Service Q( Other t8peelfy) Other ❑{spBclfy� _ f $ <br /> F.jefrlgoranE: Ice f6 Blue Ica Q alone❑ Other I2 Gommen a: <br /> Custotty Seals Ice r'hesttl C6i,3 iners No amtxtcnts: <br /> l!!Lct2ya&q Han ilLaa-?YA- a <br /> Airsemp[es reseWd2 Ye*5r N4PD All sampl—co,ralnem lnmc[P Yea HO 13 D9*00an(s)nwtcjl roc? lens No 0 <br /> OC Receiver! Emissivity: , f,OrItdIJEEr_&k Therolarnelerlo: oatrr�rme� � <br /> Yers <br /> ES Q NCI Tampture: ;Al .c t f 1— L 1 tc nne airn6 <br /> SAMPLE NLROER5 <br /> SAMPLE coNTAINEvs <br /> Ao JAaEJ16cz PE11NP7lER _ <br /> y�{,x <br /> OT <br /> IMDncArwr CRENUCAL METAM <br /> rNORCANIC CHEMICAL METALS41m FJEVjjf63z <br /> 111'QYAWK <br /> PT MYROGEN FORMS <br /> TC TALK LFIDE <br /> 20L Nrt11AYEs 0 NJ <br /> R I <br /> PTCHEM[CAL A <br /> PW.PHENOLGG5 <br /> 411=0 YOA V LALTIUV EL VI ANN 4 <br /> 411x11 VOA VEAL <br /> QT EPA 1d!-0D <br /> E'T*DGR <br /> EACTLRTOLUDICAL . <br /> -MMI:V0A VIA],504 <br /> id OkgR�Alk <br /> #T EP,4 i133J6R5l,{ <br /> T SPA 523.2 <br /> DLAWK <br /> CMI I SPA 547 <br /> 40xnl EPA 333-1 <br /> Fc¢BPA SIM <br /> OTIPJPA21015M <br /> T EPA K-AL: <br /> om! bl k <br /> $ExJIGE21330£JA1F <br /> PCD VEAL <br /> TIG LJ G <br /> TEMAR EAC' _ <br /> k[tua 1R8[4 Y <br /> FNMRE <br /> S TAnx1£ <br /> $UMhfA{'Am57ER <br /> r-QT1WW Qts: A— +C <br /> Nara lic Numhwing Cwn*4W Imo: _ DatWTlrnr, dsnaU <br /> A rAcmal t C=Cormclgd fp555P^-'mieao-m raeo e.cw�paseu7lto�rwxl <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: 1001456596 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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