My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
ARCHIVED REPORTS_XR0011850
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
F
>
F
>
5491
>
3500 - Local Oversight Program
>
PR0545028
>
ARCHIVED REPORTS_XR0011850
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
12/6/2019 5:19:12 PM
Creation date
12/6/2019 4:37:17 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0011850
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
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
61
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
CLS - V )s CHAIN OF CUSTODY( CLS ID No.; T52.05— LOG NO. 17 7 8 ~ <br /> REPORT TO: CLIENT JOB NUMBER ANALYSIS REQUESTED FIELD CONDITIONS: <br /> NAME ANDA RESS dG cop- ,, Oo <br /> It DESTINATION LABORATORY <br /> CLS (916) 638-7301 <br /> PROJECT ANAGER PHONE# 3249 FITZGERALD RD. m COMPOSITE: <br /> RANCHO CORDOVA,CA. U) <br /> PROJECT NAME 95742 m <br /> m <br /> SAMPLED ❑ OTHER D <br /> , X CL <br /> JOB DESCRIPTION <br /> C <br /> m TURN AROU TIME SPECIAL INSTRUCTIONS <br /> N <br /> SITE LOCATION CTAJ <br /> DATE TIME SAMPLE CONTAINER o N o c lo <br /> IDENTIFICATION MATRIX NO. TYPE <br /> ys It tilJul, u s It p 3 �ti c x X X <br /> cr <br /> INVOICE TO: <br /> P.O.# <br /> QUOTE# <br /> SUSPECTED CONSTITUENTS SAMPLE RETENTION TIME PRESERVATIVES: (1)HCL (3)=COLD <br /> (2)HNO 9 (4) <br /> INQ ISHED Y(SIGN) P INT NAME/COM NY DATE/TIMEREC IVED B ( GN) / PRINT NAME/COMPANY �/ n <br /> ( • AOS O AJ 'e r [.d Q `��' fie' 'r d\�- �C�J <br /> J <br /> RE A BY: D E T E' l O ) CONDITIONS/COMMENTS: <br /> SHI PED ❑ FED X ❑ U V/J LA OTHER _ AIR BILL# <br />
The URL can be used to link to this page
Your browser does not support the video tag.