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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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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 2318018 Page 2 of 2 <br /> I <br /> PACS A114YRCAL COOLER RECHIPT rGM Page of] <br /> SIlbtrli�slR>n#• - � <br /> SNrPPJrd[3 rNFOfitMATI N F <br /> HIP;J3l I CONTAIKf R FFoci Ex ❑ UPS D GSD1 GES El Haiia Darivary ❑ Bst None ❑ REE J I�CIUIR <br /> Pace Lob Field Senr]cq pi Oft)r 4 Pox D YF NO D <br /> ] ocify]_ ,� er El{Spueffy� f $ <br /> 3 !e7 a1.R[ ]ce C OfherQ C4111mflnts; <br /> ❑Rastadh}sa r� FG-che-St❑ Cant$Jhera❑ laxrro C4rnmB1]1$ <br /> I rAac[7 Yaa�}fid rrlrr r•10 p <br /> A3rx.1fltiprosraraiwadP Yba M0 Alt Satdplos;cgrAaImDrARlEect? f;o0 <br /> jC <br /> COC Rocalvecr EmisaiVf!}� ' Coatrocr:_1ITltarrWMERer ED-I Y S o NOTem POralur¢; t o " ' ! C + Mnlystlnlr <br /> SAWI.E4'0NU ms $A Wi.E NUMBERS; <br /> y � <br /> r PE 1A[4 6 ; 6 4� P q <br /> 4¢121ocF ldta Ft UHrRPB <br /> 3 {" <br /> Y <br /> CAN CAL 1.5 <br /> rNOR HEMI A 6TAtR..__1 t[6 <br /> rr cYAH <br /> PTNrr -EN FORM <br /> PT ALSO <br /> TRA7 n1Sn:s <br /> FT'T I.OIkcAH[r N <br /> PTclig�u�caLoorvc�rJJaerrtANo _ <br /> Peh r'JJlII;EL0LICS <br /> 4pm1 vvA_(JAL TRAYRL hIwSWGL _ <br /> b7.3 VOA V1 6 - <br /> ytT ESA[6i4B <br /> ,rr as <br /> RALTFRI CAL <br /> aD a1 lfw'soa <br /> OT EPA SIS-U23S.IA <br /> TEPA <br /> T 2S2 7AAVIR I.iHR: <br /> 411 SJ4 <br /> 4qn NFAi31.3 ' <br /> Orsi EPA Saa.1 <br /> 3{4.2 <br /> EPA J?allhi <br /> TEPA <br /> Us 0 16m f72en ARVER <br /> f rRe2!}2e[] A <br /> I L SJf EVE <br /> I <br /> FCR V463, <br /> FI rcjmc <br /> TI'DL.LRuAr: <br /> -EI <br /> ENC%Dn <br /> StMI A CANIS1'EIt <br /> Sample N�rnenria�Carnpfvted Eiy; pafeFT3rnc, <br /> A=Atlual C <br /> 0 C= arfadvd IwassdSlzniz <br /> IF�rweu�oxLusaeae uenecx.rt.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: 1001457978 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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