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ARCHIVED REPORTS_XR0007087
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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E
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88 (STATE ROUTE 88)
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14000
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3500 - Local Oversight Program
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PR0544811
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ARCHIVED REPORTS_XR0007087
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Entry Properties
Last modified
11/20/2024 9:21:17 AM
Creation date
9/5/2019 1:16:54 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007087
RECORD_ID
PR0544811
PE
3528
FACILITY_ID
FA0000091
FACILITY_NAME
Colonial Energy CE 40138 (DBA Power Mart)
STREET_NUMBER
14000
Direction
E
STREET_NAME
STATE ROUTE 88
City
LOCKEFORD
Zip
95237
CURRENT_STATUS
02
SITE_LOCATION
14000 E HWY 88
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\wng
Tags
EHD - Public
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SEACOR Chain-of-Custody Record Chats-of-Custody Number <br /> FieldOffice 5Additional documents are attached, and are a part of this Record <br /> Address 3 4 TH �� <br /> Job Name Q <br /> Location E <br /> LOC k Q <br /> Protect#N0005, Analysis Request-U O r- b ( _ Task#L QC-B2 i <br /> Project Manager :101W b &IL <br /> Laboratory &Q V if&G CD <br /> �7 N <br /> Turnaround Time_ [). 2D AIf$ ,. A`r d� x U E U <br /> re w O <br /> _h <br /> om <br /> Samplers Name Z ' a <br /> Samplers SlQnatUrw ( m >Nmm <br /> -60 Z' m <br /> U ao ao a 0 and m� mo oCc m U Comments/ E <br /> Sam le ID hate Time Matnx x F ao P w r- a o >(a z w u)w cL 0 1-;z 0.g Instructions z <br /> U fi- /x.30 Sa�� v SI 9 ZI /Ll aw� aR w�1G #` 31 <br /> W3 - `fs `' 15: f ii <br /> S 9 Z3 <br /> 5 eclat Instructions/Comments Relinquis edby Receied <br /> Sample Receipt <br /> Sign <br /> Sign Total no of containers <br /> Print R r.,- Print G P Chain of custody seals <br /> Company n Company 4 ec'd good condition/cold <br /> Time Date�z' 1'y Time O a pat Conforms to record <br /> Relinquished by Received by <br /> Sign Sign Client <br /> Pnnt Print Client Contact <br /> Company Company <br /> Time Date Time Date Client Phone <br /> Date _�oZ - Page -C�- of �� <br />
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