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ARCHIVED REPORTS_XR0011859
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_XR0011859
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Entry Properties
Last modified
12/6/2019 5:25:51 PM
Creation date
12/6/2019 4:43:47 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0011859
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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SJGOV\wng
Tags
EHD - Public
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2795 2nd Street, Suite 300 <br /> Davis,CA 95616 <br /> Lab: 530.297.4800 1 <br /> ANALYTICAL ctc Fax: 530.297.4808 Lab No. �l 39 <br /> Page of <br /> Project Contact(Hardcopy or.PDF To): . California EDFReport? _ <br /> - � Y. No . <br /> A JDA Chain-of-Custody Record and Analysis Request <br /> C mpany/A dress: , „a Viele yam section: <br /> Sampling Company Log Code: <br /> Analysis Request <br /> Phone No.: FAX No.: Global Ip: - - _ - Ti . <br /> 00 coo <br /> rojecl Number: PONO EDF Deli able Yo nail Address} 2 Ui <br /> N X C <br /> Projwec�t Name: j__ Sampl r g u $ �i � � ¢ � CD <br /> 4 O <br /> ,f�!DO i�G T/(JIel1/'VI `� o � w c� c� q CO <br /> ¢ W L �6 <br /> Project Address: m x z <br /> +v v <br /> _ "M <br /> tCwl�fVi <br /> Ch D-Co a Preservative Matrix y o C w-- ° 7 m <br /> O �v Y m o c0 m `m m �° O <br /> _> > tx m r] yC a > r8n t v � LL <br /> UJ X <br /> Sample Designation Date Time v T = Zt v z ►�- n= 4 0 0 0 0 m a c L <br /> t! 0 - . . <br /> 096 0 - IQ <br /> 0 <br /> Relinquished by: Date Time Received by: Remarks: <br /> Relinquished by: Date Time Received by: <br /> Relinquish�b , Dale T" Ree ed b boratory, t/ ' Bill to: <br /> Distribution: White-Lab, Yellow-File,Pink-Originator <br /> Formslcoc 12100I.th9 <br />
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