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ARCHIVED REPORTS_XR0002621
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_XR0002621
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Entry Properties
Last modified
2/3/2020 6:33:11 PM
Creation date
2/3/2020 11:20:51 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002621
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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aunr+g iqrvrma[ton AiphaA al cal, Inc .� <br /> Name v 255 Glen venue,Suite 21 . <br /> Address L1 �c ✓1�i✓rr! / Sparks, a 85431-5778 <br /> Page# of <br /> =J=-- <br /> City,State,Zip C6t_L <br /> Phone (775)355-1044 ' <br /> Phone Number15VLAi 45-nj Fax i(CZJ L. Fax (775)355-0406 Analyses Required 0837 ,i� <br /> s <br /> Client Name J(T 705 r J Pp # <br /> 1 y L 't 71& Z Job# <br /> Address J 1 PWS# DWR# <br /> City State Zip / Phone# Fax# <br /> �.C.r�✓r9 'V 3' � � �l� <br /> Time Date Malrx. OffiJniy se Sampted by/J L ReportAttenti .1 �� <br /> Se Totaland lypeof (J <br /> Sampled Sampled y {j T containers 1_ �( <br /> Below LahlDNumber 5amplet]escnption "Seebelaw �1 .1�{ ` REMARKS <br /> (V92 -03 ryi w -3 <br /> Uu3 -o,,- Mw - 5- 5%V JI'L_ x k S4 x <br /> �9Nom - yV Sc SC <br /> 5� -tom wo C6LV X �- <br /> _ Mwo `Sy v <br /> M w 0 Y z i=V K <br /> ADDITIONAL INSTRUCTIONS <br /> na re Print Name Company Date Time <br /> Relinquish <br /> e y &_ <br /> v v'h`fUs ` j�v 3d <br /> Received by(7�z LISA Ll.3, c> <br /> Relinquished <br /> Received by fie,, jl f <br /> Relinquished by <br /> I <br /> Received by <br /> I <br /> 'Key AQ Aqueous SO Soil WA Waste OT Other L Liter V Voa S-Soil,lar 0 Orbo T-Tedlar B-Brass P-Plastic OT-Other <br /> NOTE Samples are discarded 60 days after results are reported unless other arrangements are made Hazardous samples will be returned to client or disposed of at client expense The report for the analysts <br /> of the above samples is applicable only to those samples received by the laboratory with this coc The liability of the laboratory is limited to the amount paid for the report <br />
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