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ARCHIVED REPORTS_XR0002605
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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H
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HARLAN
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15600
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3500 - Local Oversight Program
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PR0545273
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ARCHIVED REPORTS_XR0002605
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Entry Properties
Last modified
2/3/2020 6:04:22 PM
Creation date
2/3/2020 11:16:02 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002605
RECORD_ID
PR0545273
PE
3528
FACILITY_ID
FA0000174
FACILITY_NAME
JOES TRAVEL PLAZA
STREET_NUMBER
15600
Direction
S
STREET_NAME
HARLAN
STREET_TYPE
RD
City
LATHROP
Zip
95330
APN
19620079
CURRENT_STATUS
02
SITE_LOCATION
15600 S HARLAN RD
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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s • � <br /> 2795 2nd Street,Suite 300 <br /> IFF Davis,CA 95616 <br /> Lab 530 297 4800 <br /> ANALYTICAL tcc Fax 530 297 4808 LabNa Page of <br /> PMect Contact(Hardcopy or PDF To) California EDF Report? Cl Yes ❑No Chain-of-Custody Record and Analysis Request <br /> revor sum Tock, <br /> Company/Address FlOcOnTnordki IYA rwWwIddaAkwirr- <br /> � Sampling Ownpany Log Code T -0 Analysis Request <br /> Vd 1 o,✓. 3 r 'Y' uS'IN eve .a X <br /> Phone No 7 FAX No / 1 11D <br /> $3G-GG 3 2 �3Cc <br /> el T_ '� 'Co O 7- -Co,�s= 9''J � m <br /> W <br /> Prged Number PO No EDF Deliverable To(EmaA Address) o w m Y O <br /> 9&27'00!-Y N N Q <br /> Project Names 5 Signature w 0 2 w m o <br /> Projed Address L 4LT)i re Sampling ontainer Presemlive Mat ix _ t e <br /> 1 m _ 4 <br /> Q a y r <br /> d W O n m = y n <br /> Q J a� <br /> E <br /> U z W 0 a a x a <br /> 0 t a n <br /> Sample Designation Bate Time q N s s _ z 3 m LO F.- J > <br /> 144vW —2 <br /> I IL 111v <br /> wa j �,po of <br /> Relinquished by Date rime Received by Remarks <br /> unshed by Date Tiine Received by <br /> Relinquished by' <br /> Date Tone Received by Laboratory ldsii� B111 to <br /> 51AW) <br /> Forms/coc 121001 fig <br /> Distdbudon White Lab, Yo bw-FR& Pink-Originator <br />
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