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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
Tags
EHD - Public
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1-0-2719 Al tr # <br /> ENVIRONMENTAL SCIENCES <br /> Chain of Custody and Cooler Receipt Form for 2318012 Page 2 of 2 <br /> Of <br /> PAC��.hIALYVICAL <br /> C00l R fRECEIP a FQRM pa j <br /> o„ubtj115slarr#: �}y SikIPPI CONTAWER FREEIIOU{a <br /> L <br /> SHIPPImG INFGt`WITION YE SCO ❑ <br /> Jtsnd arllueLY Q Ica CheeQ None g >�01€ 4 <br /> Fed L a UPS Cl G 80�GL&D othor ❑{Specify)- 1 <br /> O[hpr[] Spa-Ify) <br /> pace Lab F1 Ld s Brrlee , <br /> 1Ge <br /> Bltl#Ice[:I Nom El other❑ COrnmants: <br /> piafrl er=ttt <br /> CLtstody&E"JS Ice CheGto Containers{] done GammenRs: <br /> llpl aCL?YESj] aY] In190¢Yea NO x rNOkch COcz Vas M13 13 <br /> le¢rJpgiltlo9+siL5tEckfi Y8a F;o❑ Pc9cliptfvu[ } <br /> A1Lsamptearoeai d? Y MID All 5anp <br /> EjnissklkY +6- {ppLmliprer- l P� T1lorrnonw 0: - �. RI"'B <br /> coc Rie"Ivad + ." .c r {c .- -G hnalymfUa Hs <br /> I Y-E^s ❑NO YOTaluro: l l� <br /> ;1,PJy5I°LL-tauratlt�s <br /> �+ahf'1-�C4tlTsdtl�s t r a A $ p <br /> E U ES <br /> yasr4oaf15e2 7'6UHPVtn <br /> Y ra <br /> 7 RC IC i M Lfi i Eos dos <br /> "ANI10L <br /> NrF CEM1 <br /> 7 SO BE <br /> 2oe.v43 FN trrrk <br /> TAA, C CAMMU <br /> IA. 4C5 <br /> 49 V AL VB RLhN <br /> dD-1 VIA <br /> 7 EPA YGp-0 <br /> NT4 a[t <br /> TLS61 LOGFC/.L <br /> p Tp rCA1 <br /> oaIV VrAL.iOf <br /> Tb D3801111-10061A _ <br /> QT WA St`itr9Y9!IA <br /> LT 25b DAVE-01L <br /> 415.1 <br /> dg.jLF M3. <br /> 0.EPA MI <br /> t ' s+T <br /> Tfv SCIM <br /> T Inc <br /> y7rr] 132e 19531 <br /> idaxt �c <br /> S <br /> WE <br /> prn A3, <br /> I_45CI HA <br /> DAG <br /> 13 1DM v <br /> ENLME <br /> ShuBTYLIT , <br /> R�kti1P1A CAN61'1SR <br /> FtCV;1D5r2*IW <br /> �opYlrlen4a: � r'r oatc�filpnt` ��u.AD�acroanu*su�REa„r11 <br /> gaarlp[a plombcrlN9 tarrl[dB3v�aS" <br /> p.�Aerdsl � G=Carr+Ydad <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: 1001457971 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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