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ARCHIVED REPORTS_XR0008391
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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S
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SANTA FE
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23569
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2900 - Site Mitigation Program
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PR0541936
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ARCHIVED REPORTS_XR0008391
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Entry Properties
Last modified
5/18/2020 12:11:27 PM
Creation date
5/18/2020 11:28:57 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008391
RECORD_ID
PR0541936
PE
2957
FACILITY_ID
FA0006149
FACILITY_NAME
RANCH MARKET
STREET_NUMBER
23569
Direction
S
STREET_NAME
SANTA FE
STREET_TYPE
RD
City
RIVERBANK
Zip
95376
CURRENT_STATUS
02
SITE_LOCATION
23569 S SANTA FE RD
QC Status
Approved
Scanner
LSauers
Tags
EHD - Public
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0 <br /> r &P P Chain-of Custody Number <br /> SECOR Chain-of Custody Record <br /> Feld Office 0,y7 h Additional documents are attached, and are a part of this RArd <br /> 1p_� <br /> Address 30,1 _. SO- 7V APQ Job Name <br /> ('17'70 Location 3sCo`,' S.w •� RDC - — <br /> Project# 0�7'Y'LOOG• 0010 Task# Analysis Request <br /> Project Manager �.+rg- <br /> c <br /> Laboratory LEE h�NAuf'RGh(. - -- �o � �, � 4N <br /> Turnaround Time22 C <br /> cc <br /> �- <br /> y 'u <br /> z: o 21— <br /> Sampler's <br /> 1 -�? ° 3 m c <br /> Sampler's Name (D,1W - M a a m p`o iso o y o d <br /> N '7 r D r.- -a CO 0 47 <br /> Sampler's Signature_ a, a v i°CO e'o ODm 'm o <br /> o cv � E�5 1,� m N oma° ti $ Comments/ E <br /> U da a. o 20 oN 0o �N vo Oa U H <br /> 1 <br /> Sample ID Date Time Matrix r �- Q > z N n tO ^ a �' Instructions Z <br /> I r ~ <br /> 0 l�{n1`� (o r 0� 0�'s� MCM1 <br /> Special Instructions/Comments Relinq ed Received by Sample Receipt <br /> Sign Sign_ Total no of containers <br /> PrintPrint Chain of custody seals <br /> Company Compa Rec'd in good condition/cold <br /> Time 9215 Dated co Time Date Conforms to record <br /> Relinquished by Receive by -T J 4. Ghent <br /> Sign Sign <br /> Print Print D_,%.1. Client Contact <br /> Company Company k. tF <br /> T Date Time ��S'_-_ Date DO Client Phone <br /> sECCR CUS7REC Rev 2/BB <br /> Date 6 / / 00 -_ Page of <br />
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