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ARCHIVED REPORTS_XR0004531
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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3500 - Local Oversight Program
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PR0545484
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ARCHIVED REPORTS_XR0004531
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Entry Properties
Last modified
3/11/2020 1:18:24 AM
Creation date
3/10/2020 11:13:14 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004531
RECORD_ID
PR0545484
PE
3528
FACILITY_ID
FA0003714
FACILITY_NAME
LACHHAR CHEVRON*
STREET_NUMBER
334
Direction
E
STREET_NAME
MAIN
STREET_TYPE
ST
City
RIPON
Zip
95366
APN
26115041
CURRENT_STATUS
02
SITE_LOCATION
334 E MAIN ST
P_LOCATION
05
P_DISTRICT
005
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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Chain-of Custody Number: <br /> SECOR. - _Chain-of Custody Record Mderkmpq OoC <br /> Field Office: 07 -7 Additional documents are attached, and are a part of this Record. <br /> Address: G �� ��..� �_ lr Job Name: 1- 1452- M1 L <br /> . ocation: �. • ... <br /> Project# 0'72!=O-` Y5:2-- sk# d Analysis Request <br /> Project Manager �.-• <br /> Laboratory Gam' t o °r° v <br /> Tumaround Time =i; `* 6 �, <br /> 82 o <br /> � mm <br /> Sampler's Named 1.-'B W n: I n g o r <br /> Sampler's Signature 0° € a � m N o a w <br /> =r 2 u7 t m c0 r a <br /> z <br /> Sample ID ate Time Matrix z m CO d� io m °ti Q rte- Instructions 73 <br /> E <br /> 1 <br /> Special Instructions/Comments: Relin 's y: ei�ed by: Sample Receipt <br /> s kJn Total no.of contairiers: <br /> Print S Print Chain of custody seals: <br /> Company Company Rec'd in good condifloNcold: <br /> Time ©a#e l t Time Date Conforms to record: <br /> Relinquished by: Rec ' ` y: �c Client: <br /> Sign , Sig <br /> Print int Client Contact:_ 10= <br /> Company! Compan {- <br /> Time .-AO-'10 dDate E Time DateOML Client Phone:�f <br /> secoscusrnEc rte,.M <br />
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