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ARCHIVED REPORTS XR0006135
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0544590
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ARCHIVED REPORTS XR0006135
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Entry Properties
Last modified
6/21/2019 4:04:15 PM
Creation date
6/21/2019 11:17:54 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006135
RECORD_ID
PR0544590
PE
3528
FACILITY_ID
FA0003932
FACILITY_NAME
KWIKEE FOODS
STREET_NUMBER
2081
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12315225
CURRENT_STATUS
02
SITE_LOCATION
2081 COUNTRY CLUB BLVD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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Tags
EHD - Public
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❑ 885 Jarvis Drive a Morgan Hill, CA 95037 o (408) 776-9600 o FAX (408) 782-6308 <br /> jSEQUOIA ANALYTICAL ❑ 819 Striker Ave., Suite 8 - Sacramento, CA 95834• (916) 921-9600 FAX (916) 921-0100 <br /> ❑ 404 N.Wiget Lane o Walnut Creek, CA 94598 • (925) 988-9600 FAX (925) 988-9673 <br /> 1W CHAIN OF CUSTODY ❑ 1455 McDowell Blvd. North, Suite D • Petaluma, CA 94954 • (707) 792-1865 FAX (707) 792-0342 <br /> ❑ 1551 Industrial Road o San Carlos, CA 94070 • (650) 232-9600 FAX (650) 232-9612 <br /> Company Name: - Jirw-w Project Name: y,�v DS <br /> Mailing Address: 336 -,o- C , Billing Address (if different): <br /> City: Y� S 'State: ( Zip Cade: Q5"Z5 Z <br /> Telephone: U ci--7 a—-3 41-0 FAX #: � P.O.#: <br /> ,r a� <br /> [Report To: c v r � Sampler: V OC Data: eve! D (Standard) ❑ Level C ❑ Level B ❑ Level A v <br /> Turnaround ,?10 Working Days 0 3 Working Days D 2-8 Hours 0 Drinking Water W r Analyses Requested -)e <br /> Time: ❑ 7 Working Days ❑2 Working Days ❑Waste Water <br /> ❑ 5 Working Days ❑24 Hours ❑Other <br /> Client Date/Time Matrix # of Cont. Sequoia's iW <br /> Sample I.D. Sampled Desc. Cont. Type Sample# 4 �� Comments <br /> Cdp <br /> 2. r—Z Cr <br /> a) <br /> co <br /> 3. F- <br /> 4. y � <br /> 5. K r-� --05 ,.. <br /> 6. <br /> 7. Kr- _-7 - <br /> s <br /> Cr <br /> 10. <br /> Relinquished By: Date: � p Time:�,' Received B : <br /> Relinquished By: Date: Time: Received By: ate: Time: <br /> Relinquished By: Date: Time: Received By: Date: Time: <br /> Were Sams, .- Received in Good Condition? Cl Yes U No Samples on Ic U Yes U No Method of Shipment Pag ,of <br />
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