My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
ARCHIVED REPORTS_XR0011799
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
F
>
F
>
5491
>
3500 - Local Oversight Program
>
PR0545028
>
ARCHIVED REPORTS_XR0011799
Metadata
Thumbnails
Annotations
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
Scanner
SJGOV\wng
Tags
EHD - Public
Jump to thumbnail
< previous set
next set >
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
241
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
SHAHUIH TECHNOLOGY, INC. 2- <br /> /01t7_ .--HAIN OF CUSTODY RECORD <br /> Analytical L `<>>ratory <br /> Phone:(916)362-8947 )Li.' C. No. 25201 <br /> e.4112 Sacramento, 1 .7 <br /> 3050 File Circle, — —_ CA 95827 FAX,(916)362-0947 Page -�_ 0&�, �i JAL I <br /> Company: Phone: Invoice Number: <br /> A o-toeM REQUEST <br /> Project Manager: FAX: REMARKS: <br /> Report Address: Billing Name&Address: Sampler's Name: <br /> All None Some <br /> Project Name: f" W f%yD6-X ct/Job#: 0 OK OKI OK WET(STLC) <br /> Project Location: �pr <br /> Cooler Temp. 0C <br /> RO.#: Sample Condition <br /> TCLP <br /> pM <br /> Preservative TCLP Total <br /> Samplin g Container Used Matrix TAT <br /> W <br /> F_ S OD <br /> C <br /> Ln a) <br /> Lr) N A <br /> 2 z c\1 Ln C6 N0 <br /> 0- fn <br /> (b (D v JC <br /> 'D C\1 <br /> Z5 a Lo (L <br /> 0 ao U3 <br /> L!1 E 4_3 CVw 0 <br /> 0 _C� 0 0 Ca (D <br /> IL <br /> < ca Im C\1 00 co M 76 12 w a) <br /> EL 0 <br /> 0 0 0 0 C\r N 6 0 (a a) <br /> a) 0 (L co N .6 a, 5; <br /> > -0 0 16 .0 Q <br /> E z co co -4 2 Q) 'D <br /> L: 0 0 0 C%J C\J -5 .9 r- 2 <br /> EWZEW ;� q) X OL. =CO �au) <br /> 2 _J 0 C <br /> NO. SAMPLE ID Date Time LO C) F)G z 0 0 0 w uJ V <br /> -C <br /> (L C<1 ca W <br /> < 1 0 w w ui w w w 0 < < , B 0 0 <br /> 1 1 1 z cc 0 0 _3 U) CZ I n-- <br /> 2 <br /> 3 <br /> 4 <br /> 5 <br /> 6 <br /> 7 <br /> 9 <br /> 10 <br /> I — <br /> R F-ILA J54y,'- 1 L <br /> Ff e Relir*ishdjby: ------- <br /> Received by: <br /> Time:Date:Date: Time: Date: m Time: LL-2 0 Date: Time: Date: i Time. <br /> 'PLEASE READ REVEASE SIDE <br /> FOR TERMS AND CONDITIONS <br />
The URL can be used to link to this page
Your browser does not support the video tag.