My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
ARCHIVED REPORTS_XR0005115
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
M
>
MOFFAT
>
229
>
3500 - Local Oversight Program
>
PR0545566
>
ARCHIVED REPORTS_XR0005115
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
9/23/2020 10:37:59 PM
Creation date
3/17/2020 4:41:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005115
RECORD_ID
PR0545566
PE
3528
FACILITY_ID
FA0005479
FACILITY_NAME
MANTECA BEAN CO
STREET_NUMBER
229
STREET_NAME
MOFFAT
STREET_TYPE
BLVD
City
MANTECA
Zip
95336
CURRENT_STATUS
02
SITE_LOCATION
229 MOFFAT BLVD
P_LOCATION
04
P_DISTRICT
005
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.
/
40
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
a 4080 BIKE LANE, SUITE C CHAIN-OF-CUSTODY RECORD 29003 <br /> CONCORD, CA 94520 AND ANALYSIS REQUEST <br /> i N V I R o N1�k 'f� NO <br /> 0) 685-7852 '" �I ',I n, ' - ^,i�4.�;,` .t ,..i ,, F��x,•�_��4." <br /> cAeoeAro i11 �$J jC 1423-7143 , ', 'i , ` 'a ` ,>aAll <br /> Company Name, y ;°; n` _ Phone# tO) 67I` , <br /> G rote 4 c i r t w#. CGY� Q FAX# 510 US; `I J ❑ � � } � <br /> b 'R <br /> Company Address Qor} Cti; N S location ''' _ ' ❑ <br /> r {r . 1 I icIHC4 �.n ❑ ❑ C�3 <br /> �c 4 -9 ❑ ❑ <br /> Project Manager; �,I M1�t`,�+,r Client Project ID (#} 0a0-7b3r79 . 6 l0q v * N -9 1:3 s <br /> ___(NAME) ►, ►► o ❑ 0 ❑ 0 ❑ ❑ .' i` ❑ d f''i ❑ <br /> I attest that the props fleld;pampling Sampler Name{Print} # o ❑ ❑ o J J a <br /> procedures were use'Nuring the collection " � v �, N m ¢ ¢ <br /> of these sam les, MLI�'k CZt ❑ g a "' '� a o N a g ¢ O ❑ <br /> vii m ¢ ❑ bo m ❑ O U rt` <br /> Matrix Method Sampling Q o a ¢ ¢ ❑ <br /> Field. GTEL preserved a o X w W UJ co o a V ❑ ,❑ <br /> ❑ s = = ❑ a a ❑ <br /> , Sample Ir Lab # o o: o ti <br /> ID r {Lab use only) v -J o f o F w .n m ¢ ¢ ¢ a a a ¢ <br /> a o d a z L` � ¢ r- n ca a o a a a a a a v a a 'O tg <br /> a y a 0 x x x L oN a i= m m z x d w w w w w w w w u i w U <br /> 'M ca z IZ" <br /> AS <br /> N <br /> x <br /> J;7, <br /> b.o�. <br /> .F <br /> 16 of <br /> TAT Special Handling SPECIAL DETECTION LIMITS REMARKS <br /> 51 <br /> P o �Z24 hry ❑ GTEL Contact <br /> i48 hr) ❑ QuotelContract ix Q�.g3QOt{ ?O/' <br /> J 1. <br /> �9a Days ❑ <br /> Confirmation k <br /> h PO# SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot# Storage Location <br /> aye <br /> e 19 <br /> ,a QA 1 QC LEVEL <br /> CLP❑ OTHER a �1: �l <br /> FAX ❑ Work Order# C.3 ! ��-. /-3 <br /> Relinquished by Sa rr Date Time Received by <br />' - USTODY Relinquished by Date Time Received by <br /> ,RECORD Relinquished by Date Time ReceivedbyLaboratory <br /> Roy Trot I Waybill # <br />
The URL can be used to link to this page
Your browser does not support the video tag.