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ARCHIVED REPORTS_XR0012582
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1804
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3500 - Local Oversight Program
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PR0545493
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ARCHIVED REPORTS_XR0012582
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Entry Properties
Last modified
3/11/2020 1:53:49 PM
Creation date
3/11/2020 8:45:36 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012582
RECORD_ID
PR0545493
PE
3528
FACILITY_ID
FA0009460
FACILITY_NAME
Stockton Center - EBMUD
STREET_NUMBER
1804
Direction
W
STREET_NAME
MAIN
STREET_TYPE
ST
City
STOCKTON
Zip
95203
APN
14505027
CURRENT_STATUS
02
SITE_LOCATION
1804 W MAIN ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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_ mss 'a: _ -^- -- - - MIRE, <br /> -� - -`, . <br /> 10 <br /> >. <br /> a <br /> ;,SPLERS: <br /> . HAIN OF CUSTODY RECO,_) <br /> (5lpnarun) <br /> SHIPPING INFORMATION <br /> hone: 50 <br /> n Shipper <br /> Address 1975 V STREET <br /> 403 oateShi 93706 <br /> RESNO pPad <br /> �� 937 Shipmentservice <br /> Alrbsll No. <br /> ATTENTION: Cooler No. <br /> i <br /> Phone No. <br /> e , linquished by:(Signature) ecawed b <br /> Date/limse <br /> r I nqulahed :(S:QnatunJ Received by:l5�9naturel ,✓ <br /> ate/Time <br /> a nqu s @ y:(Signature) <br /> ace ved by:r..FQrsrurel Date/Time <br /> e nq0 s e y:(Signature) Receive for laboratory by': ,gnerure) ate/lima <br /> (. 'Analysis laboratory should complete,"sample condi;lon upon receipt",section below,$ign and return top copy to <br /> j J.H.KL£iNFELDER 3 ASSOCIATES,1975"E"Street,Fresno,California 93708. <br /> r Sample Site Date <br /> Analysis <br /> Anal sis <br /> Sample Condto <br /> nNumber Identification Sampled Requested Upon Receipt <br /> r6= 8'ry <br /> �L, <br /> TP A 4- <br /> -3-2.9 <br /> -- 5 <br /> - _ � _ _ <br /> Y LAB INSTRiItTIONS: Laboratory reports should reference and be billed by site IRI and contain the following: <br /> E ] sw=ry of analytical i methodology L �.detes for {a] s and work (trucks, spikes. duplicates) <br /> amplin g, {bf lab receipt, (r.) extraction, (d) infection/analysis <br /> { etactlonlislts for till constituents analyzed for areporting of all constituents detected which were not <br /> specifically dosignatnd ad <br /> .� { I <br /> i Yhite - Stingier Canary - J. N. Kleinfelder a Associates <br /> Pink - Lab Courtesy Copy <br /> - <br />
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