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ARCHIVED REPORTS XR0007691
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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EL DORADO
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400
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3500 - Local Oversight Program
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PR0544653
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ARCHIVED REPORTS XR0007691
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Entry Properties
Last modified
7/11/2019 7:07:34 PM
Creation date
7/11/2019 2:46:39 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007691
RECORD_ID
PR0544653
PE
3528
FACILITY_ID
FA0004695
FACILITY_NAME
BRIDGESTONE/FIRESTONE #3573
STREET_NUMBER
400
Direction
N
STREET_NAME
EL DORADO
STREET_TYPE
ST
City
STOCKTON
Zip
95201
APN
13907009
CURRENT_STATUS
02
SITE_LOCATION
400 N EL DORADO ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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� � � � � � � �M � � tttttttttt• � � � <br /> USTODY A <br /> A n �S I T I V E 781 East Washington Blvd, CHAIN <br /> A SOF CS RELIUEST <br /> NIF <br /> Los Angeles,CA 40021 ! I DATE 5/. <br /> /_ t 1 PA f 1 <br /> LPI LAB SERVICE (213)745-5312 FAX(213)745-6372 LOG BOOK NO 4 li 11 FILE NO LAB NO <br /> CLIENT NAME !_ 7h r ' L� f ANALYSES REQUESTED AIRBILL NO- <br /> COOLER TEMP. <br /> PROJECT NAME _ ]�. 1 PROJECT NO y� y PO NO <br /> PRESERVED- <br /> ADDRESS 1.; � >r ,; �++t=1 aY �tiT Z�4 L ��rrcrt at-oc—P, C& f �`�� QC REPORT <br /> PROJECT MANAGER ,� �+:': +�.��n p�r� PHOIV &>S -71� FAX NO• ` A. 7 LEVEL: <br /> SAMPLER NAME 0 7 �t f tU M .C_c s ,n�U REMARKS <br /> ( inted) (Signature) <br /> TAT(Analytical Turn Around Time) 0=Same Day, 1 =24 Hour, 2=48 Hour, (Etc),N NORMAL <br /> c <br /> CONTAINER TYPES B=Brass,G=Glass,P=Plastic, VOA Ysf,O=Other <br /> SAMPLE DATE TIME MATRIX CONIAINER SAMPLE CONDITION/ <br /> NO SAMPLED SAMPLED SAMPLE DESCRIPTION WATER SOIL IeLLIDGE OTHER TAT a TvPE ICOMMENTS <br /> 5 _ <br /> IV P, <br /> Il1U rlr%- l ,� J - <br /> r <br /> Rel qulkhad By(Signalur d P Na e) Races i n and Printed Memel ate T' SAMPLE DISPOSITION � <br /> t 1 1 Samples returned to client) YES �NO _J <br /> Relinquished By(Signature SA Printed Name} Received By(Signature and Prmted Nemel Date Time <br /> 2 Samples will not be stored over 30 days unless I <br /> Relinquished By(Signature and Punted Name) Received By(Signature and Printed Name) Date Time additional storage time IS requested <br /> 3 Storage time requested days <br /> SPECIAL INSTRUCTIONS <br /> 18y date <br /> CLIENT COPY _ - <br />
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