My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
ARCHIVED REPORTS XR0004322
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
M
>
MAIN
>
1399
>
3500 - Local Oversight Program
>
PR0544686
>
ARCHIVED REPORTS XR0004322
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
7/23/2019 11:47:19 AM
Creation date
7/23/2019 11:34:14 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004322
RECORD_ID
PR0544686
PE
3528
FACILITY_ID
FA0000916
FACILITY_NAME
7-ELEVEN INC #19976
STREET_NUMBER
1399
Direction
N
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
95336
APN
21633034
CURRENT_STATUS
02
SITE_LOCATION
1399 N MAIN ST
P_LOCATION
04
P_DISTRICT
003
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.
/
108
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
aWNT 90mcm M ism M w Aw -r c� <br /> ° CHAIN O CUSTODY Ron <br /> d'' . Y� 7 S-g .-i r s ` �yam£ r P e of r <br /> �� r CU5TOMER INFORMATI., ON"t '` F 2,cv� PRO,IBCT I 'IFORMATION-~ � � 4_ _ � <br /> COMPANYPR 1F)N BER c:1'A y <br /> p ro <br /> SEND REPORT TO n j; <br /> BILLING <br /> �' f r G INFORMATION <br /> z <br /> ADDRESS / /}r M1 BILL TO <br /> z� ',Fz�jo 4z <br /> - ' <br /> ADDRESS LAB JOB NO <br /> Inc ��`r�; <br /> LU �,� ��1�2.3 <br /> PHONE PHONE C,&.. 4, <br /> FAX �! FAX PO NO 2Zi <br /> J G <br /> $AMPLE z SAMPLE • r <br /> SNNPGEND ' 5�� µ "4SAN�LE DESCfiIP[ON pr�7 � 5* �OATE. ' <br /> lc-?,--[IME 1, ' MATRIX CCWAINER PRESERV;" Fir .REMARKS 1 PRECAUTIONS <br /> Ki C�� _ r, t <br /> ,tea N� <br /> l In 3 2,, V3117 <br /> 17 <br /> 2- 33 0 ' <br /> T <br /> I c'c? SAMPLER SHIPMENT METHOD AIRBILL NO <br /> � — <br /> rr REQUIRED TURNAROUND* I 1 SAME DAY L 1 24 HOURS !` 48 HOURS 72 HOURS (]5 GAYS [DI 10 DAYS ROUTINE OTHER <br /> c`1 RELINQUISHED BY :" s p 1 - DATE '2iRELINQUISHED BY DATE 3 RELINQUISHED BY GATE <br /> 'a SIGNATURE SIGNATURE SIGNATURE <br /> a PRINTED NAMFICOMPANY �✓ �! TIM PRINTED NAMEICOMPANY TIME PRINTED NAMEICCMPANY TIME <br /> 1.f <br /> z ('RECEIVED BY:'' : ? "_ DAT 2 RECEIVED BY e DATE 3 RECEIVED BY DATE I <br /> cr <br /> SIGNATURE SIGNATURE SIGNATURE <br /> in <br /> x �'� <br /> PRINTED NAMErPAF�Yy� � _/ TIME PRINTED NAME? MP NY a TIME PRINTED NAME CDMPANY TIME <br /> t 1((,. ff� r �ic� <br /> ❑ Anaheim CA ❑ Aurora CO D Carson CA ❑ Caspar WY ❑ Cerpua Chrlstl Tx ❑ Edleon NJ <br /> 1250 E Gena Autry Way 10703 E Se%any DrN@ 21730 S Wilmington Ave Su6e 201 420 W First Street 1733 N Padre Island Drive 284 Raritan Censer parkway <br /> Anaheim CA 92805 Aurora CO 60044 Carson CA90810-(640 Casper WY 82601 Corpus Cnnsa TX 76408 Edison NJ 08837 <br /> (714)937 1094 Fax 1314)937 1170 (303}751 17801F-{303)751 1784 13101 513 2031 Fax(3101 513 2035 13071 235 5741 Fax(307!266 1676 (512)289 2673 Fa.1512)289 2471 1732)225 6700 Fax(732)225 6777 <br /> ❑ Houston TX(Env) D Houston TX(Pat) D Indlanapolls IN 11 Lako CAartes LA D Vafparalso IN <br /> 6310 Rodlway,Drive 6210 Mosley Road 7726 Moller Road 3645 8egks parkway 2400 CumhenaM Onve <br /> Houston TX 77040 Houston TX 77075 Indlanapohs A 46268 Sulphur LA 70663 Valpaiarso IN 46383 <br /> 91 464 2]89 Far(219)<52 295z <br /> (713)690-N44 Fax 1713)690 5646 (713)943 9775 Fait(7 13)943 3846 (317)675 5994 Fait(317)8726589 1316)563 4926 Fa.1318)583 4929 (21 <br />
The URL can be used to link to this page
Your browser does not support the video tag.