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FIELD DOCUMENTS_CASE 1
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0545492
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FIELD DOCUMENTS_CASE 1
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Last modified
3/13/2020 11:57:10 AM
Creation date
3/13/2020 11:10:13 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
FileName_PostFix
CASE 1
RECORD_ID
PR0545492
PE
3528
FACILITY_ID
FA0000309
FACILITY_NAME
MCHENRY STATION & MINI MART
STREET_NUMBER
1405
STREET_NAME
MAIN
STREET_TYPE
ST
City
ESCALON
Zip
95320
CURRENT_STATUS
02
SITE_LOCATION
1405 MAIN ST
P_LOCATION
06
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\sballwahn
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EHD - Public
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[ t t ( t t <br /> EARTH TREATMENT Y T <br /> ENVIRONMENTAL CONSULTANTS Mrft turn-around <br /> CHAIN OF CUSTODY RECORD <br /> PROJECT NAME: <br /> 3o I Number of �ti _-p <br /> �� a <br /> SAMPLER (signature) : y <br /> Containexa/Sat, <br /> Type of <br /> Date Time Sample Location Sample <br /> c q Lab I.D. <br /> 8 $: -2-01- z Bs- -7 -s ` eR` � �c s P- 8`19 5 <br /> It I 't-00hm Zof - -7 - 10' ►� <br /> 'r - 05Z 48&- - l3. ' .. '� 6 q7 <br /> :oa 301- 0826 5 T- l8. " •` `` f Z <br /> N ►' 03 t-d 2 '-1 - Z. ` " ►+ x 9q <br /> Z: 015-nb8 - "7- +G ' 1 c' ►rK o <br /> elin uished y: Date / Time Received by: Relinquished by: Date / Time Received by: <br /> F►s o��n� C InIL. <br /> Company: 5 ' Com an : Company: Company: <br /> Relinquished by: Date / Time Received by: Relinquished by: Date / Time Received by: <br /> Company: Company: Company: Company : <br /> Relinquished by : Date Time Received by: Relinquished by: Date Time Received by : <br /> Company: Company Com any: Company: <br /> NOTE: In preparing legal documents always use ink and signatures <br /> P.O. BOX 2242 (209) 384-1041 MERCED. CA 95340 <br />
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