My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
ARCHIVED REPORTS_XR0012768
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
L
>
LOUISE
>
1196
>
3500 - Local Oversight Program
>
PR0545438
>
ARCHIVED REPORTS_XR0012768
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
3/9/2020 4:28:38 PM
Creation date
3/9/2020 2:03:48 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012768
RECORD_ID
PR0545438
PE
3528
FACILITY_ID
FA0000848
FACILITY_NAME
QUIK STOP MARKET #2121
STREET_NUMBER
1196
Direction
W
STREET_NAME
LOUISE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
APN
217-410-43
CURRENT_STATUS
02
SITE_LOCATION
1196 W LOUISE AVE
P_LOCATION
04
P_DISTRICT
003
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.
/
12
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
C' o +55 <br /> North State Environmental Analytical Laboratory Chain of Custody/Request for Analysis <br /> 90 South Spruce Avenue, Suite W, South San Francisco, CA 94080 Lab Job No.: Page"Jof ! <br /> Phone: (650) 266-4563 Fax: (650) 266-4560 <br /> Client: [a,.r /„�vG` J- 0-1t)Su:.c- , 2,-u . Report to: 0-10l Phone: 17,2 _Y26 _s-3y'S Turnaround Time <br /> Mailing Address: Billing to: Fax: 5�» <br /> 7,02D ko6/ plr;w y sh,,� PO#I Billing Reference: Date: J7-17- ao <br /> sem. /.3i1 <br /> %e.a5.4u C-4 1�SWr� 1 /JS ~ 3 Sampler:Ila. k <br /> Project/Site Address: Analysis <br /> Requested <br /> ii9L E- u: c C4,q-_,kc4 <br /> Sample ID Sample Container Pres. Sampling C9 Comments 1 Hazards <br /> Type No. /Type Date/Time <br /> - 2 <br /> w.+k, IV6 A UcL ?17 o /B:oo <br /> w- 3 ,4 7 oo ie, 'YD <br /> i <br /> p <br /> Relinquished by: Date: 2t7166 Time: a;Y' Received by: Lab Comments <br /> Relinquished by: Date: Time: Received by: <br /> Relinquished by: Date: Time: Received by: <br /> i <br />
The URL can be used to link to this page
Your browser does not support the video tag.