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SU0008175 SSNL
EnvironmentalHealth
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JACK TONE
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PA-1000071
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SU0008175 SSNL
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Entry Properties
Last modified
5/7/2020 11:33:24 AM
Creation date
9/6/2019 10:22:31 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SU0008175
PE
2622
FACILITY_NAME
PA-1000071
STREET_NUMBER
11951
Direction
N
STREET_NAME
JACK TONE
STREET_TYPE
RD
City
LODI
Zip
95240
APN
06321015, 16
ENTERED_DATE
4/2/2010 12:00:00 AM
SITE_LOCATION
11951 N JACK TONE RD
RECEIVED_DATE
4/1/2010 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\J\JACK TONE\11951\PA-1000071\SU0008175\SS STDY.PDF
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EHD - Public
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A & L WESTERN LABORATORIES, INC. <br /> o <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 0 Phane 204529-4080 <br /> CHAIN OF CUSTODY <br /> ; <br /> Client /V Z 7 Phone <br /> Address CC to: <br /> . Zip <br /> Signature of person authorizing work i <br /> under terms stated below* <br /> *Nei 30 days, All accounts past due will be subject to interest ch/arges of 1.5% per month. <br /> *Hazardous materials are the property of the client. The client is responsible for proper disposal of hazardous wastes. Clients not <br /> picking up hazardous wastes may be assessed an appropriate fee. <br /> PROJECT la No. ANALYSIS <br /> of <br /> Con- <br /> SAM PLE P'BY: (sigpature): tain- <br /> ers <br /> REMARKS <br /> a,"ple <br /> Date Time type <br /> Sample Location <br /> Glob C "P- <br /> Relintjujshed by(signature): Oat? Time Received by(signature): Date Time <br /> Relli14-u-Ished by'(signature): Date Time Received by(signature). Date Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> I I <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> Site Time: Driving Time: <br /> Start: Finish: Total Hours: Start: Finish: Total Hours; <br /> Dedicated Exclusively to Providing Quality Analytical Services <br />
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