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ARCHIVED REPORTS_XR0007098
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_XR0007098
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Entry Properties
Last modified
11/20/2024 9:21:18 AM
Creation date
9/5/2019 1:32:17 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007098
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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Tags
EHD - Public
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Chain-of Custody Number: <br /> SECOR Chain-of Custody Record. <br /> Field Office: <br /> D{ Saga M��+ D Additional documents are.attached,and are a part of this Record. <br /> Address: r 73Y- 3((tkS� Job.Name: <br /> �ecr-aMcn'�`o f _ Location: C o I <br /> L. e.), <br /> Project# e 0 O (-Of � Task# � Analysis Request� o� ' <br /> Project-Manager <br /> Laboratory co <br /> a . <br /> Turnaround Time <br /> o a m � �9 <br /> Sampler's Name m. o lema a . o: S r . ID <br /> Sampler's Signature. c, +� x g J <br /> , r E C', <br /> o Comments/ <br /> Sample ID Date .Time Matrfx x �. x+� i N a Instructions Z <br /> cJ B� D <br /> 7-170tvos, AK6 0 <br /> Mw 4rrO15,_ <br /> Mw Y 70 13:18 oz- p p i <br /> MW <br /> h4o 1- <br /> Zi <br /> OJT- lS•S' 6fa t- <br /> 1 <br /> Z f " :5 \ IOfo <br /> VJ1A61�0 S07qte <br /> Special Instructions/Comments: Relinquished by: Receiv d by: Sample Receipt <br /> Slgn. Sign Total no.of containers: <br /> Q L `"L L S.�'����s Print Print Wo <br /> !Z_ Chain of custody seals: <br /> oICompany Compan UNT/L rup-off Recd.In good condition/cold: <br /> Time '•d Date' s Tlme `n -%. . _.r-,at67JtWb Conforms to record: <br /> Relinquished by:' Received by: <br /> Sign Slgn Client: <br /> Print Print r <br /> Company Company Client Contact: .f• <br /> Time Date Time Date Client Phone: Irl! <br /> �ECOR OUSTREC Rev.ims <br /> hF Date: Pnaof <br />
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