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ARCHIVED REPORTS_XR0011799
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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F
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F
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5491
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3500 - Local Oversight Program
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PR0545028
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ARCHIVED REPORTS_XR0011799
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Entry Properties
Last modified
12/6/2019 5:21:13 PM
Creation date
12/6/2019 3:46:21 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0011799
RECORD_ID
PR0545028
PE
3528
FACILITY_ID
FA0003919
FACILITY_NAME
VAN DE POL ENTERPRISES
STREET_NUMBER
5491
STREET_NAME
F
STREET_TYPE
ST
City
BANTA
Zip
95304
CURRENT_STATUS
02
SITE_LOCATION
5491 F ST
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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41-AHULH-1 L-GHNOLUG Y, INC. [CHAIN OF CUSTODY RECORD <br /> :,yora ory <br /> Analytical <br /> t Phone:(916)362-8947 No. 2 5 7 4 6 <br /> 3050 File Circle,#112 Sacramento,CA 95827 -YOO FAX:(916)362-0947 Page 2- of STAL Invoice Number: <br /> Company: F\q)Qry- EAVl(01 4Qf-- k Phone: ANALYSIS" R' 'EQUEST <br /> Project Manager: - 'Om �,-p�,n Q-,r\r FAX: CMD �s- CQCJ-1 REMARKS: Sampler's Name: <br /> Report Address: Billing Name&Address: S am 1\\i <br /> LA\-k mo.,Vo;or, NV L A* lQ <br /> L'>� NMI— VV <br /> Project Name: PjAll Noh, e Some <br /> roetIJb# — <br /> UOx. OK WET(STLO) <br /> Cooler Temp. <br /> Project Location: <br /> ROM: Sample Condition TCLP <br /> pH <br /> Preservative TCLP Total <br /> Sampling Container —T--F—T—T— <br /> Used Matrix TAT <br /> UJ <br /> C2 <br /> Lo' a) N <br /> C6Nz <br /> U) <br /> Go <br /> Na <br /> LD <br /> L) U) <br /> Q1 O E NO d N CV <br /> LU N m <br /> 0 U) U3 <br /> Wa- 00000E? .d <br /> co C\1 co co It r- <br /> 000NN (Dow <br /> co lz <br /> IL a, <br /> 0 <br /> 0 IL 00 co <br /> U) .0 _J (0 U) a �? �p !�2 .6 -J <br /> Z C co �r Ln = 2 -2 <br /> -JMEEL.: zo N a) <br /> E U) (0 co (.0 (D (D Q a- C 7 19 <br /> 21 <br /> C\f < 0 <br /> a- f<L a< <br /> NO. I SAMPLE ID Date T!m e 1 0 :2 <br /> in 0 C I w ;O� < < <br /> coU) W I w I z 0 0 0 in a: M <br /> 2 <br /> F,--)T <br /> 3 <br /> 7� <br /> 4 <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> by: <br /> Rel' o� <br /> wished by: Reqe Relinquished by: Received by: <br /> u t� <br /> Date-q1 \\\CA'S- ITime: a ,-10D ate: C, Time. 3.'YL2 Wj Date: Time: Date: Time: <br /> PLEASE READ REVERSE SIDE FOR TERMS AND CONDITIONS <br />
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