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ARCHIVED REPORTS_XR0003101
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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J
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JACKSON
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1702
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3500 - Local Oversight Program
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PR0545315
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ARCHIVED REPORTS_XR0003101
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Entry Properties
Last modified
2/11/2020 11:50:47 AM
Creation date
2/11/2020 9:55:10 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003101
RECORD_ID
PR0545315
PE
3528
FACILITY_ID
FA0003572
FACILITY_NAME
DAVES UNION SERVICE
STREET_NUMBER
1702
STREET_NAME
JACKSON
STREET_TYPE
ST
City
ESCALON
Zip
95320
APN
227-14-011
CURRENT_STATUS
02
SITE_LOCATION
1702 JACKSON ST
P_LOCATION
06
P_DISTRICT
005
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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' Trace Arial is <br /> yei Laboratory, Inc. <br /> 3423 Investment Boulevard 48 + Hayward, California 94545 Telephone (590) 783-6960 <br /> Facsimile (590) 783-9592 <br /> _ CHAIN OF CUST0DY RECORD <br /> Proj.No. Project Name <br /> X02 � k�o`....� �5 c pt1o.� No. <br />' Analyses// / <br /> Company Name and Address: <br /> ��z,~ ���a•.�.c. �{.�S tc. Boz of <br /> Project Manager:— <br /> Sample Date Time Site Location Con- / CL/ <br />' ID tamers REMARKS <br /> Itivo V&1 <br /> I <br /> Sampled by• signature) Date/Time R 1 nqujsh d by• (signature} D to/Time <br />' :L •�' ��j0 �i }f:�r5 <br /> WV by: (s tore) Date Time eli fished by: (signature) at /Time <br /> 11 zV <br /> 11:;t5 ��._ /zgls. <br /> 0119 <br /> S_ <br /> Recei ed for Laboratory by: (signs ur a e/Time TURNAROUND TIME <br /> I � <br /> REMARKS SampTe t must be filled in-by lab <br /> Ice or <br />' Preservative: <br /> q Heads ace• <br /> Container Type: —7e k J74 <br /> Total Number of Containers- 2 <br /> Other: --' <br /> P/u� <br /> Founding Member of the Association of California Testing Laboratories <br /> I <br />
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