My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
ARCHIVED REPORTS_XR0004165
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
K
>
KETTLEMAN
>
601
>
3500 - Local Oversight Program
>
PR0545338
>
ARCHIVED REPORTS_XR0004165
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
2/12/2020 10:27:36 AM
Creation date
2/12/2020 8:41:30 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004165
RECORD_ID
PR0545338
PE
3528
FACILITY_ID
FA0003803
FACILITY_NAME
KETTLEMAN CHEVRON
STREET_NUMBER
601
Direction
E
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
04728006
CURRENT_STATUS
02
SITE_LOCATION
601 E KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
32
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
K KAPREALIAN ENGINEERINGe INC. V <br /> CHAIN OF CUSTODY <br /> SITE NAME i ADDRESS I ANALYSES REQUESTED ! TURN AROUWO TIME: I <br /> (SAMPLER I ! <br /> f\J LOD II I I I ! I I I ! <br /> IWITwI sstMc ACEWcr I 60 % C . Kr-8 T Ti LE/n <br /> I I I I I I <br /> NO- <br /> OF ! SAMPLING I I I I I ! ! ! <br /> ID W0. ! BATE I TIME I SOIL JUItTERIGRABICOMPICOWT.I LOCATION <br /> ? Z4 Za$ <br /> ZR3 <br /> AV <br /> X13 <br /> Zq S7 46 4 <br /> Ix I7I 1 <br /> Ii I I I ! Ci I �! I nl X I I I I ! I Z�� <br /> I I I ! ! Ix l I u l ! xl x I ! ! I ! I ! <br /> I �� � I/ I I I S I I � t. l I �• I S I I ! I � I 3°U� � <br /> (Relinquish (Sign ture) I Date/Time I Rec ved [Si atur The following MUST BE completed by the laboratory accepting samples I <br /> I I 1I 9 I for analysis: ! <br /> T. Wave all samples received for analysis been stored in ice? I <br /> fReli ished I 2S I <br /> rqu try; (Signature) I Date/Time I clued (Si Cure) <br /> 12. Will samples remain refrigerated until analyzed? I <br /> I <br /> IReiinquished by: (Signature) Date/Time I Received by: (Signature) 13. Did any samples rec ived for analysis have head space? I <br /> sales in appropriate tontainers and properly packaged? I <br /> (Relinquished by: (Signature) I Date/Time I Received by: (Signature) P I <br /> � I � <br /> Signature line Datc I <br />
The URL can be used to link to this page
Your browser does not support the video tag.