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ARCHIVED REPORTS XR0000896
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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C
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CALIFORNIA
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300
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3500 - Local Oversight Program
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PR0544147
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ARCHIVED REPORTS XR0000896
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Entry Properties
Last modified
2/14/2019 2:51:31 PM
Creation date
2/14/2019 1:18:39 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000896
RECORD_ID
PR0544147
PE
3526
FACILITY_ID
FA0004522
FACILITY_NAME
SKIPS SERVICE STATION
STREET_NUMBER
300
Direction
S
STREET_NAME
CALIFORNIA
STREET_TYPE
ST
City
STOCKTON
Zip
95206
APN
14909501
CURRENT_STATUS
02
SITE_LOCATION
300 S CALIFORNIA ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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WNg
Tags
EHD - Public
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-- ANALYTICAL REQUEST/SAMPLE CHAIN OF CUSTODY— LAB.TRACKING #: <br /> RECORD OF DATE RECIEVED: .............._...._.......... <br /> r <br /> -__F L <br /> LAB.INVOICE TO: <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES <br /> 10624 OLIVE AVENUE,OAKDALE,CA.95361 - - 3----}- - -------- -------..... .t-----vr--.+...------ <br /> OFFICE-(209)847-8757 <br /> FAX -(209}647-7744 PH --- ---) ONfAGT: ---� --------------------------------------------------- <br /> CALIFORNIA CONTRACTORS LICENSE#6573661 CLASS"A"ENGINEERING' <br /> OB# ---------.--_._.----I OI #-_..__.... .--_....._....P.O.# ------------------------------------ <br /> Ho j; LAB.ANALYSIS REQUESTED, <br /> Ii. SITE SAMPLNG MAP rl,liII iikr ril „iI <br /> (NOAIid <br /> CLIENT: co CONSULTANT: <br /> SITE NAME:4L4 VB&F-7- PROJECT: <br /> ADDRESS: t , CITY: ST.: t <br /> SAMPLER SIGNATURE: 14 L <br /> c r. o <br /> SHIPPED VIA: V 1"a WAYBILL#: "f^ �? A d $ 00 00 d d .4 <br /> ANALYSIS BY: TURNAROUND TIME: DAYS W w W W W <br /> ! I SAMPLE I.D.! RATE TIME CONTAINERS TYPE MATRIX REMARKS/LAB.LD. <br /> 5.) u - <br /> 6.) D3 90 <br /> 7.) 'V�J - DVI <br /> 8-) <br /> ]0.) vyw r <br /> [RELNQU1SHMBY:' <br /> Rafrroursr�nas: �� piay: <br /> SAMPLE INTEGRI�m Wt /CONAIT1aN <br /> (S)UNA1UPE) ' / ! / D/ RECEIVED COLD A INTACT 1 Y� y NO r 1 <br /> „ qa O/�' t�n�•n BY: /� /. �- / AIR BUBBLES 1N V.O.A�S r YES No LIN s R- <br /> (SIONATURE) ( f �'� � 4 CUSTODY SEALS INTACT 1 YES ( NO( 1 NIA ify <br /> I'- DATEITNE DATE P7iME <br /> RE[.n�QursllFb BY: Rr�E1vED ati: PRPSERVATNES USED ! MS NO f <br /> 3 <br /> � lsfarun-rRE� r V N S: L'� <br /> _ NOTE- PLEASE. "VE THE SAMPLES SUBMITTED ROR THE RILL HOLDING TIMI?AILOwT D,UNLESS OTHER ARRANWITS TS ARE MADE. (M.T.B.E..T.A.M.E..E.T.B.E.,D.I. .A.) <br /> * B.D.=DAILIR BLANKS COLLECIFD IN THI'I-ID,D. F.D.=F7131.I)BLANKS C01,11(1I:1)IN TIIF FOLD. <br />
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