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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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t:titttng Information Alpha An tical, Inc <br /> Name SIAWW Enid 1 CAN McNf AL 255 Glendale e,Suite 21 <br /> Address 3330M6a1(Q N " � -P S Sparks,Neva 431-5778 Page# of <br /> City,State,Zip Ci Ko fy tffcpL 5 Phone (775)355 1044 <br /> Phone Number O0_04'_ Fax 1 0 6 00 Fax (775)355-0406 Analyses Required 07993 V <br /> Client Name <br /> JOV's Tcycx P("4YP PO # Job# <br /> Address PWS# SWR# <br /> 1560o S ��tt,vra:a Qo <br /> City State Zip <br /> y A,rii&d F ' CA Phone# Fax# <br /> Elf 30 X36 on� s o bat boor <br /> Time Date Mft* Office Use Sampled by n tteponAttention <br /> Sampled Sampled See Key only li- t 1,V 5, �7 (: Tota!and type of =t cq <br /> Below Lab ID Number Sample Description `coSeebeel� REMARKS <br /> L�tsl tIZS pT bItCO`i -6l 1NF Air- I-T K X X <br /> t;�1r� ItZ3 �T <br /> 02, C-F F STD TAT <br /> ADDITIONAL INSTRUCTIONS• <br /> Signatu Print Name Company Date Time <br /> Relinquished by <br /> Receivetlby 'rQ.ip►7VS ENV <br /> Relinquished by <br /> Received by 1 <br /> Relinquished by V 7 1Z <br /> Received by <br /> "Key AO-Aqueous SO-Soil WA Waste OT-Other L-Liter V Voa S Soil,far 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 analysis <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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