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SU0010433 SSNL
EnvironmentalHealth
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SU0010433 SSNL
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Entry Properties
Last modified
5/7/2020 11:34:35 AM
Creation date
9/6/2019 11:09:26 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SU0010433
PE
2622
FACILITY_NAME
PA-1500048
STREET_NUMBER
19750
Direction
N
STREET_NAME
LOWER SACRAMENTO
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
01318050 51 52 53
ENTERED_DATE
3/30/2015 12:00:00 AM
SITE_LOCATION
19750 N LOWER SACRAMENTO RD
RECEIVED_DATE
3/27/2015 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\L\LOWER SACRAMENTO\19750\PA-1500048\SU0010433\SS STDY.PDF
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EHD - Public
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_ CHAIN OF CUSTODY <br /> m.rie r <br /> ENVIRONMENTAL AND ANALYSIS REQUEST DOCUMENT <br /> Lab Number: 4 TEST DESCRIPTION AND ANALYSES REQUESTED <br /> ICtient. Live Oak GeoEnvironmental <br /> Customer Number: 3016608 <br /> Address: <br /> 407 407 W.Oak St. <br /> Lodi,CA 95240 <br /> Phone: (209)369-0375 Fax; (209)369-0377 <br /> Email Address: abby@logelodi.com <br /> Contact Person: Abby RaccO ~ EI <br /> North Forty,19750 N.Lwr Sacramento,Acampo <br /> Project Name: 3 7 � <br /> jl p a: I <br /> Purchase Order Number: <br /> Quota Number: <br /> Sampler(s): Jessen WeICh... <br /> j o 4v <br /> Sampling Fee: Pickup Fee: " p <br /> Compositor Setup Date: Time: in <br /> co <br /> Num p g z n m r n ` m <br /> Sam Location Desctt tion Date Time Sampled Sampled <br /> �m <br /> `1 I0 Travel Blank � D� (S, G 2 G X �• "- <br /> 1 Domestic Well I DW FIC11 0 4 <br /> _P <br /> r <br /> i a _ <br /> I <br /> I i <br /> P <br /> N , <br /> I <br /> Remarks kl— <br /> ling Relinquished <br /> s . <br /> wished e• Time: Rahn cashed Date: Time: Relinquished Date: Time: <br /> m • Received B : Date: Time: d Received By: Date: Time: <br /> A'// Received By: Date: Time; Y <br /> Office Laborato Office&Laboratory Field Office <br /> 853CorporaterpOffices Street Laboratory ry 563 E.Undo Avenue Visalia,California <br /> 853 Corporation 9306Stockton, <br /> Stagecoach Road 95926 TEL:559/734-9473 <br /> Santa Paula,CA 93060 Stockton,CA 95215 Chico, 0/ 43-58 <br /> TEL:805/392-2000 TEL:209/942.0182 TEL:5301343-5818 Mobile:559/737-2399 <br /> FAX:805/525-4172 FAX:2091942-0423 FAX:530/343-3807 FAX:559/734-8435 <br /> CA NELAP Certification No.01110CA CA ELAP Certification No.1563 CA ELAP Certification No.2670 <br /> 1 <br />
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