My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
ARCHIVED REPORTS_XR0012521
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
N
>
99 (STATE ROUTE 99)
>
18846
>
3500 - Local Oversight Program
>
PR0545627
>
ARCHIVED REPORTS_XR0012521
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
11/19/2024 1:50:34 PM
Creation date
4/28/2020 4:45:02 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012521
RECORD_ID
PR0545627
PE
3528
FACILITY_ID
FA0003883
FACILITY_NAME
VICTOR FINE FOODS
STREET_NUMBER
18846
Direction
N
STREET_NAME
STATE ROUTE 99
City
LODI
Zip
95240
APN
01709051
CURRENT_STATUS
02
SITE_LOCATION
18846 N HWY 99
P_LOCATION
99
P_DISTRICT
004
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
-- ANALYTICAL REQUEST/SAA CHAIN.OF-CUSTODY LAB TRACE3NG : - 3M <br /> r n_ <br /> RECORD OF DATE RELIEVED <br /> . . <br /> DELTECH GEOTECHNICAL SUPPORT SERVICES LAB.INVOICE TO: <br /> 10624 OLIVE AVENUE,OAKDALE,CA.95362 <br /> OFFICE-(209)847-9757 = <br /> FAX -(209)847-7744 PH.B ( --- � CONTACT - <br /> CALIFORNIA CONTRACTORS LICENSE X1657366/CLASS"A"ENGINEERING <br /> OB# 1 OICE1; —P.O. – = <br /> � liiiii Nllll!,!�I,',i',! 111!111!I!I k !!! !!I'ill!IIII li ullli3l !IJ i' I IIIIIIJI li i.;i.!I! ,!I I!!!II'!1111171111 i1;!;ti!'.�ull II II III!I Ili I I1i11 I1i11.1,''!!!!!!li!!!!11!!111!! LAB.AlKALYffi3 RxA2uFSTF� SITE SAMPLING MAP - <br /> CLIENT: CONSULTANT <br /> �V <br /> SITE NAME PROJECT: <br /> ADDRESS: N CITY: ST.: s' 15 � � o <br /> == <br /> SAMPLER SIGNATURE: L C o m o W <br /> cD <br /> 13 <br /> SHIPPED VIA: WAYBI LL M �7 Ap7 d g Go cc <br /> 6 d H <br /> ANALYSISBY: TURNAROUND TM: DAY( F Rl w So W <br /> f,', SAMPL—F LD.I nATE TWE CONTAINERS TYPE MATRIX 111111' I!!!lii 111!!111 ILII: I!il1!!I !1111111 !!EE I! III Ill# 11#111; !il;l' REMARKS/LAB.I.D. <br /> 4.) _ - <br /> 5) - <br /> 7.} <br /> 8.) <br /> 10J <br /> I1) <br /> 1 Z.) <br /> 13.) <br /> 14.) <br /> 15.) <br /> DATE 1 TGA SAMPLE INTEGRITY/CONDITION <br /> C RF.�IYFD BY: t'ri.7.T� <br /> i1F1.IIJpllLS1iFJ3 BY: 7 _ <br /> RECEYED COLD&INTACT I YE NO I <br /> r DA'1]ilTIME _ <br /> RELINQU15FffI.l BY: RE�iVF�BY: ABR BUBBLES IN V.O.A.S I YES NO LI 5 0 <br /> I (s�TURE) CUSTODY SEALS INTACT 1 NO-( NIA <br /> DATE I TIME <br /> REL]Nq 1ISH D BY; RG[E BY: PRESERVATIVES USED I YES NO <br /> TURD / (SIGNATURE) I VZLVLUWaUV <br /> NOTE: PLEASE ARCHIVE THE SAMPLES SUBM117l3D FOR THE FULL HOLDING TIME ALLOWED,UNLESS OTHER ARRANGEMENTS ARE MADE. *`(M.T.B.E.,T.A.M.E.,E.T.B.E.,D.I.P.F.,T.B.A.) <br /> B.B.=BAILER BLANKS COLLECTED IN THE FIELD. F.B.=FIELD BLANKS COLLECTED IN THE FIELD. <br /> PINK-FIELD COPT' - WHITE A YELLOW•TO LAB.WITH SAMPLES YELLOW-RETURN TURN TO CLIENT'A'1T11 RESULTS DF.1:TECII C.O.C.FORM 99 <br />
The URL can be used to link to this page
Your browser does not support the video tag.