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ARCHIVED REPORTS_XR0003972
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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L
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LOCKEFORD
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429
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3500 - Local Oversight Program
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PR0545394
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ARCHIVED REPORTS_XR0003972
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Entry Properties
Last modified
3/5/2020 3:05:46 PM
Creation date
3/5/2020 2:36:58 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003972
RECORD_ID
PR0545394
PE
3528
FACILITY_ID
FA0005372
FACILITY_NAME
MAR-VAL MARKET*
STREET_NUMBER
429
Direction
W
STREET_NAME
LOCKEFORD
STREET_TYPE
ST
City
LODI
Zip
95240
CURRENT_STATUS
02
SITE_LOCATION
429 W LOCKEFORD ST
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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I / <br /> Chain-of-Custody Number: A <br /> SEACOR Chain-of-Custody Record <br /> 43 o c 014 5 q <br /> Project # 50011 -001-65 Analysis Request <br /> Project Manager 91riALe <br /> Laboratory GTI Et.XrtM trt C,% iA f- <br /> JwV <br /> 'Ilan-around time: w r $ Comments/ <br /> I I I Instructions <br /> �^ � <br /> Sampler's Name: K rr I�.c: ss .._ \ �`� � � a � �= � <br /> Sampler's Signature: o c a z <br /> Sample ID Date Time Matrix <br /> uJ- \A Sci-2--- w X <br /> W - •. *•w-.- . *--�rE- .., ""=" gniAV`i�� IF N SAMA L.t•�No <br /> M� Z^ <br /> y <br /> J� <br /> 1 <br /> Special Instructions/Comments. Relinqui a by: Received b : Sample Receipt <br /> nn ��� Sign -- Sign 7bial no.or containers <br /> R9,kV'r loov\-Ai-awJ �' Print Jt:`"'rt Print Chain of custody seals: <br /> Company Company L Rec'd good condition/cold-. <br /> i <br /> Time L S ©ate I41Q- Time Date Conforms to record: <br /> Relinquished by: Received by: <br /> Sign Sign Client: <br /> Print Print <br /> Client Contact: <br /> Company Company <br /> Time Date Time Date Client Phone Number: <br /> Date /—/—Page—of <br />
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