My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
ARCHIVED REPORTS XR0004078
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
K
>
KETTLEMAN
>
2449
>
3500 - Local Oversight Program
>
PR0543823
>
ARCHIVED REPORTS XR0004078
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
10/22/2018 1:21:08 PM
Creation date
10/22/2018 10:38:25 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS XR0004078
FileName_PostFix
XR0004078
RECORD_ID
PR0543823
PE
3528
FACILITY_ID
FA0003760
FACILITY_NAME
SUNWEST LIQUORS
STREET_NUMBER
2449
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95242
APN
02741005
CURRENT_STATUS
02
SITE_LOCATION
2449 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
42
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
-- ANALYTICAL REQUEST/SAMPL CHAIN OF CUSTODY -- LAB.TRACKING #: - ---- ------ -r - <br /> RECORD OF _� <br /> DATE RELIEVED: <br /> LAB.INVOICE TO: -- ------- <br /> 1 L � = � ------------------- <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES�-� <br /> 10624 OLIVE AVENUE,OAKDALE,CA.95361 In w p., 1T I:0 <br /> OFFICE-(209)847-8757 ALL S PH.# (?_-q- --- 1 `11 CONTACT: ------1 ---------------------------- <br /> FAX -(209)847-7744 <br /> CALIFORNIA CONTRACTORS LICENSE#6573661 CLASS"A"ENGINEERING <br /> OB# -----------I DICE#._---------------___.P.O.# ---------�__ .. <br /> LAB.ANALYSIS RlEllt SYFD SITE SAMPLING MAP <br /> II• ..,I•'. 3 II ..._:I!i I. {I u¢. I Iil i •• i;. h,...,C •r.'. , ..,fir •' ,' tl . :.I.� .LuL..-:- <br /> CLIENT: 6 -! CONSULTANT: f t�.L ►�Zs9TL ;; * zr <br /> SITE NAME-' NtMW �1 Ll Q . PROJECT: n E-u) <br /> ADDRESS:�-{ ! 'V 1 K l, L CITY: 11M I 5T.: aI O <br /> SAMPLERSIGNATURE: �--� d <br /> O <br /> SHIPPED VIA: C4 9b <br /> L� WAYBILL#: 3 <br /> ANALYSIS By- C i TURNAROUND TAZE: P4 }> DAY(S) <br /> SAMPLE LD.a« DATE TIME CONTAINERS TYPE MATRIX :!IN. ,•,1! 'l}I`I. ',•• .; I•LI I; REMARKS/IAB.LD. <br /> I <br /> 2-) - _Z an '2-.;,i 2 <br /> <) fy\lw3 tilb ` <br /> 5) i. Z 4- r 1 <br /> 6-) <br /> 7) <br /> 8.) <br /> 9) <br /> i <br /> 3 D.) <br /> F I.) <br /> l2.) <br /> 4 3-) <br /> l4.} <br /> !5.) <br /> urlvinev: 1 V�i�('. ' SAMPLE INTEGBITY/CONDITION <br /> Y-ovWlsla-D Bl <br /> RECEIVEDCOLD&INTACT ! YES If 1 NO f ) <br /> ISIGNwTUR6) <br /> A -! DATE IIA(G <br /> pt�,wQ(llst[F-n R1 1/L/( RECEIVED BY. I A[FtBUBR1.ESIf�V.t].A.'S ! YES NO f L[NE:15 �- <br /> (WINATURE) 1 CUSTODY SEALS WTACT ! YE[ f I NO If 1 NIA i Y <br /> A .r <br /> "AITI-1 <br /> kF"I.C+QFNtit 87,91 A>•CE:IVI:DEi) PRESl;RVATIVE.S USED ! YES No f <br /> / tSIDNA-MIRE., Q11 No, V V= <br /> u <br /> I <br /> NOW, I'I.HAtiI?ARCI11VI:I IIF SAMrlj:,s sunwri'mi v R"nul vus,i.m11-I)INWIIMF AI1.OWEiD,IINI.IiSS(IFEIF.R ARRAN(pJ MWr TS AkI:MAIN{ * (M:f-11.1'..,T-A.M.1?., <br /> B[3 -BAILFR III ANKS('O[,I.F.(`Ila)IN-11[I:Iliil.i) F.13. =FIFI 1)14LANKti('OLI.Ii('1'1:1)IWI IIF1`1i1.1) <br /> PI N};-}IF.1.❑('f IF'1 kHIE'h:h\h'LLI I\5'-'I'[1 LAR WITH tiAnIrLEy NEI_LO%% -RF-1111(NTOULIEN I'A Lfll RESULTS DF.I.-TECH C0C FOknl 99 <br /> I <br />
The URL can be used to link to this page
Your browser does not support the video tag.