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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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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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ENYIRCNMENTAL BCIEHCES <br /> Chain of Custody and Cooler Receipt Form for 2318015 Page 2 of 2 <br /> ppjaF ANALYTICAL <br /> COOLER RECEPT MRDA Pae Of <br /> Sub]nlssl4n#; <br /> SHIPPING INFORMA71 Dfd SHIPP]f�G C01�TAlAIEF2 FRSE�1�1k11� <br /> Fed& ❑ UPS❑ Gs4 f Gus 0 }land GcllverY 4 Ica Chest O' Kl ne- i_k E*x ❑ 1f�3 rd fl <br /> Paco LV b rieLG 5erVkfl Ir btber D fteeffyl= OEhar D{SpasffYl�� <br /> Refd $ralnt: Ice Blur#Ica 12 lupe 0 Other 0 COMMI IS; <br /> Custiody S"IS Ica phwt Cl Corltalnera❑ UDI- Dearnmwailt ' <br /> Irmet2Y06❑ rwo t�YutE i1D 0 <br /> AN 5amploa rmc*W9d7 Yes Ho❑ AILsamplm centskrars InLant? )r" Hoa oefQlpllorlfs}match ebC7 Ya3 He D <br /> E1r�SsaWll}� ConSaSncr ThMIDMOl>ar lE): 1q f]atCmmP I <br /> CDC Received AA + 15 ' .0 Ajn2jlVBt Will <br /> eyE$ El NO TemR4mkurm 4 A I (C ) <br /> SAMPLE WuoIeCR3 <br /> 3a3rtPLE+i4ft7hIH2Rr+ A 6 7 e 8 to <br /> PE UN <br /> 4�jax114�1 rs tIHPItES <br /> .1 C ECALWTA12 <br /> [yp LMT 4-04W+ <br /> Cr I <br /> r -fgWG TORM17$ <br /> PT L 1-ML DE <br /> �.0 IN rE <br /> rT rAL t td <br /> PT CE 1 JAL EN OEM NI) <br /> ri,ar 7CS <br /> Aaml YOA VIAL oLnNJt, <br /> a.1 VIAL <br /> FPA A 7 <br /> FA01 LCGI <br /> SAC 111 <br /> mt ADA V7 i[FI <br /> T yp�11'lf0a83iil� <br /> Q-r8Fh515.f7ai#l�i <br /> 7 6 <br /> 515.2 <br /> FA QS• <br /> eopi P.PA 57 <br /> ao.nl Ltr 531.1 <br /> ErA .a <br /> P 3011 <br /> TEPA WC <br /> gpst LtiateM aAMe6 <br /> 3oel1 1323 R <br /> MLSL VE <br /> PC8 VIAL <br /> '31C <br /> TLS R 13AG <br /> ENG Hik <br /> SW RT Kn <br /> SUM A(7&NJS3Fa <br /> CummenlS: Dal. inne: na+slasnrJat <br /> Sample MLI u lmg ComPlabad L3W� ay xwmclus,.vneca.fil <br /> Is:m6ro�rA4s [ p <br /> A-A-Ml I 0=0--cLed <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: 1001457974 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.pacelabs.com Page 4 of 12 <br />
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