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FIELD DOCUMENTS
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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3500 - Local Oversight Program
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PR0545292
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Last modified
2/10/2020 7:45:24 PM
Creation date
2/10/2020 4:54:53 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0545292
PE
3528
FACILITY_ID
FA0003631
FACILITY_NAME
ONE CANLIS
STREET_NUMBER
24
Direction
S
STREET_NAME
HUNTER
STREET_TYPE
ST
City
STOCKTON
Zip
95202
APN
14914024
CURRENT_STATUS
02
SITE_LOCATION
24 S HUNTER ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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f_.._..,: 4.,.�.,:• rn. k rep" r---,� i..— .l lam.-..: .p <br /> -f 1,_ - i r, ll.,,a: L .�...s!� ( m:� l = •4�.. '_. 1,,, <br /> �... -7 1,--- <br /> NEL LABORATORIES CHAIN QF CUSTODY <br /> Reno - Las Vegas <br /> Phoenix - Burbank Project Name: TC — C h IIS Project No.: <br /> R. <br /> P.O.No.: Sampled By: o e /2 q r„r A l f— <br /> Burbank Division 700 S.Flower Street-Burbank,CA 91502 J <br /> (818)841-4985-Fax:(818)567-6477-1-800-320-6595 <br /> Company: CRgh4011 a <br /> .AV, Coll <br /> .f <br /> o Analysis <br /> Address: /Wo C4nlova ir11Qy, Su)te top <br /> Rahcl,2a M422rie � � G A .55p,5693 o O <br /> Phone No.:(9lb\ Zr 4_32SO Fax No.: �316) 3S1I - 32SI _ x C V_ .. <br /> Billing Address: r/gJh,7,) l Expected Due Date:n „xx j2 <br /> J 7 - •+rn` " > lb ,o' iK Hevt�eP �I� <br /> 1 I <br /> Requested Turnaround: X SDay(Normal)_48Hr._24Hr._Other o w X ��pVS °` fOf10 9ehgle <br /> n Q , <br /> Sample Date/Time Sample ID N.E.L. Identification " a- W Remarks <br /> Id'1191 91 }3p 5 - 8 ` SO L <br /> o ; 191 vw 56j 9. 5 I SO F L XXX I <br /> In 91 no sz'-G- ZO - 1 SO <br /> Iv� 5 1 915 56- ��`1 1 50 E HXX <br /> it) 91 9 '3 <br /> `llS SI&- 6" 0 _ ) SD F H Praienccvo e <br /> N4re rade,ci <br /> ti 194 lots SR- 6 -35 - I so k MXX <br /> Io 31 Id'15 SR - h GW - G W A M <br /> i <br /> Boz p1 DW-Drinking Water <br /> SO-Soil Box W2 A.HCI E.Ice Only BOx q3 H-High <br /> Custody Seal intact? Y N None Temp. WW-Woofswater SO Solid 8.HIND F.other M-MetlWm <br /> RW-RCRA Wat¢r "AO-Aqueous C.H SB, G.Not Preserved L-Law <br /> Condition when received good OL-Oil A-Air D.NkR u- <br /> Unknown' <br /> SG-Sludge <br /> Relinquished by + Received by <br /> (Print) (Signature) - Date(rirtle (Print) `.. (Signature) y Date/Time <br /> JD 4! 1 <br /> ( �A to t)-T 110o F E ox - �- cQyddv <br /> �q M'1a rn.�. -f <br /> 3 <br /> 4 <br /> This repod is applicable only to the sample received by the laboratory.The liability of the laboratory b limited to the amount paid lor this report.This report is for the exciushe use of the dient to whom It b addressed and upon the¢ondilldn that the client assumes all liability for the further <br /> detribulion of the repos or its contents. <br />
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