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ARCHIVED REPORTS_XR0002622
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_XR0002622
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Entry Properties
Last modified
2/3/2020 6:15:06 PM
Creation date
2/3/2020 11:21:28 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002622
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 /> Billing IgiWation Alpnalyttcal, Inc <br /> Name --... a�y`� �� ��11MIZ.Yt _ 255 ale Avenue,Suite 21 <br /> Address _;__373 0 �6.VVW Y'0 V) r&Y k IS(- ,+ —,5-0 Sparks,Nevada 89431-5778 Page# of <br /> City,State,ZipPhone (775)355-1044 a <br /> Phone Number�`E?0) 67�_�!L#gFax(5-301G-7& C'Cv� Fax (775)355-0406 Analyses Required U7 AL <br /> Client Name PO # <br /> 3Ct r� �'fv��C �t � �;� Job# <br /> 4 <br /> Address // '2—o�"�—Iy��v01 <br /> A4 v fLt N c-c"Qj PWS# DWS p �u <br /> je <br /> City State Zip�Yv � t� Phone# Fax# I+, <br /> J <br /> Office Use SampledybW ! t � ReportAttenlionTime Dale See Key Only Total and type of <br /> Sampled Sampled <br /> l Mainers <br /> W <br /> Below Lab ID Number Sample Description "See below REMARKS <br /> bd �°laa Aa <br /> ADDITIONAL INSTRUCTIONS. <br /> E32�AAlk " � -A i <br /> ]] i nature Print Name Company Dale Time <br /> Relinquished by `A� &A' . <br /> Received b <br /> f ' <br /> y <br /> Relinquished by t y f <br /> Received by <br /> Relinquished by <br /> Receivod by <br /> 'Key AQ-Aqueous SO-Soil WA-Waste OT-Other "' L-Liter V-Voa S Soil Jar 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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