My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
ARCHIVED REPORTS XR0006876
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
E
>
E
>
103
>
3500 - Local Oversight Program
>
PR0544638
>
ARCHIVED REPORTS XR0006876
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
7/9/2019 2:37:16 PM
Creation date
7/9/2019 2:00:18 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006876
RECORD_ID
PR0544638
PE
3528
FACILITY_ID
FA0004027
FACILITY_NAME
HENDRIX FORK LIFT INC
STREET_NUMBER
103
Direction
N
STREET_NAME
E
STREET_TYPE
ST
City
STOCKTON
Zip
95205
APN
15318001
CURRENT_STATUS
02
SITE_LOCATION
103 N E ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\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.
/
29
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
CHAIN OF CUSTODY 1 LABORA ORY REQUEST ANALYSIS EST FORM <br /> N Q <br /> 1433 North Market Boulevard,Sacramento,CA 95834 Service Request No �j����� J 1'U Number NIA Paige I of 1 <br /> >1 MCOIn (916) 928-3300 FAX(916)928-3341 Lab CAS ,r <br /> Project Name Teichert-Stockton Analysis Re uested <br /> Project Number20F90-002 004,Task 001 <br /> Project Manager Matt Turner <br /> Company EMCON <br /> Address 1433 Norllt Market Boulevard <br /> a <br />� Sacramento,CA 95$34 U <br /> Phone (916) 928-3301 c <br /> FAX (916) 928-334 r u <br /> Sampler's Signature x <br /> Z REMARKS <br /> Sample LAB Sample I lConiainerTypes <br /> ID Date Time ID Matrix HCl Preservauom <br /> MW-9 2fz1% mo , water 2 2 <br /> MW-10 1215 water 2 2 <br /> MW-Il ?qo J water 2 2 <br /> MW-13 13 ZO ¢ water 2 2 <br /> MW-14 1350 water 2 2 <br /> El EI ti 1) 7,e'v' <br /> I) REI INQIIISIII DIIV R14EIVI I)111 1URNAROUND R1•PI)RI Ri QVIR1 Nil NIS <br /> y(— RI-t,1111R1 MI NIS X I RoL1111ll RtptariI(rt+uul� f nrlc tilgtiutur� Signature zitu +n i„ sdnr II Ittpn1111ntluth ,01W NIS <br /> 11 i Y-C r LL X standa,d(-t0 15 wo"S days) MSB,as required,may be <br /> Pnnted Name Printed Name Printed Name Printed Name Ptovtde urinal Preliminary Results charged as saniph s) <br /> EFALO \ .5 Provide t AX PKitlmna y Results III Data Validation R,,port <br /> Ft / Firm Firm Finn Reyursted krpori Dale (lnLiudes All Raw Data) <br /> R 1'o 10C r� ��D /Iry RWQC$ <br /> Datclrif tt1 Cli Dat the tcllirnc DarcJrtrne (MDLs/PQLs1TRACEU) <br /> RLLINQRIISHhD JLt RECEIVED BY Special Instructlens(Comments Container Types Key <br /> 40 ml VOA I <br /> Signature Signature 125 mi LPE 2 <br /> 500 mt LPE 3 <br /> Printed Name Printed Name I titer HDPE 4 <br /> 500 ml glass 5 <br /> Firma Frrm 1 liter glass 6 <br /> 2x6 sis nng 7 <br /> M- rr elabs lar 9 <br />
The URL can be used to link to this page
Your browser does not support the video tag.