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COMPLIANCE INFO_2015-2019
EnvironmentalHealth
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1600 - Food Program
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PR0539648
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COMPLIANCE INFO_2015-2019
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Entry Properties
Last modified
10/7/2020 1:43:57 PM
Creation date
7/24/2019 11:49:46 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2015-2019
RECORD_ID
PR0539648
PE
1609
FACILITY_ID
FA0022688
FACILITY_NAME
RUSTIC CRUNCH
STREET_NUMBER
3958
Direction
W
STREET_NAME
SARGENT
STREET_TYPE
RD
City
LODI
Zip
95242
APN
02514003
CURRENT_STATUS
01
SITE_LOCATION
3958 W SARGENT RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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• <br /> INVOICE _°ter`°. <br /> IIIIIIIIIII Remit To: <br /> o ` <br /> FGL Environmental •�.;,a�o,,;,�., <br /> InVOice# g35g52A 853 Corporation Street <br /> Santa Paula,CA 93060 <br /> Ron Hittle Account#3013723 <br /> 3958 West Sergent Road Date Billed Amount Due <br /> Lodi, CA 95242 05/22/2018 $62.00 <br /> Date Due Amount Paid <br /> 06/21/2018 <br /> To ensure that your account is properly credited,please return top portion with payment <br /> Keep bottom portion for your records. <br /> INVOICE `mom <br /> ENVIRONMENTAL AGRICULTURAL <br /> ,{ , •,f <br /> Analytical Chernsts <br /> aeso <br /> Account# Date Sampled Lab Number <br /> Ron Hittle 3013723 05/03/2018 STKI835852 <br /> Invoice# Date Billed Amount Due <br /> 835852A 05/22/2018 $62.00 <br /> Date Paid Date Due Amount Paid <br /> Check Number 06/21/2018 <br /> Description of Work Quantity Rate Charge <br /> $actiAn l�vsis � <br /> Coliform-Quanti Tray 1 33.00 33.00 <br /> Support Analysis <br /> Sampling-Sampling 1 29.00 29.00 <br /> Total 62.00 <br /> (S MH-NL) <br /> Corporate Offices&Laboratory Offlaa&Laboratory Office&Laboratory Office&Laboratory Office&Laboratory <br /> 853 Corporation Street 2500 Stagecoach Road 563 E.Undo Avenue 3442 Empresa Drive,Suite D 9415 W.Goshen Avenue <br /> Santa Paula,CA 93060 Stockton,CA 95215 Chico,CA 95926 Sen Luis Obispo,CA 93401 Visalia,CA 93291 <br /> TEL:(805)392-2000 TEL:(209)942-0182 TEL:(530)343-5818 TEL:(805)783-2940 TEL:(559)734-9473 <br /> Env FAX:(805)52511721 Ag FAX:(805)392-2083 FAX:(209)942-0423 FAX:(530)343-3807 FAX(805)783-2912 FAX:(559)734-8435 <br /> CA ELAP Certification No.1573 CA ELAP Certification No.1563 CA ELAP Certillcetion No.2670 CA ELAP Certification No.2775 CA ELAP Certification No.2810 <br />
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