My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
ARCHIVED REPORTS_XR0008839
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
T
>
12 (STATE ROUTE 12)
>
13889
>
3500 - Local Oversight Program
>
PR0545719
>
ARCHIVED REPORTS_XR0008839
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
11/19/2024 3:45:50 PM
Creation date
6/3/2020 11:28:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008839
RECORD_ID
PR0545719
PE
3528
FACILITY_ID
FA0005335
FACILITY_NAME
CHARLES JACOBS
STREET_NUMBER
13889
Direction
W
STREET_NAME
STATE ROUTE 12
City
LODI
Zip
95240
CURRENT_STATUS
02
SITE_LOCATION
13889 W HWY 12
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
LSauers
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
57
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
[• � t• (♦ l� � i i tl• i i i i■ 1• t� f� � <br /> Advanced CHAIN OF CUSTODY CORD <br /> Date I 1-1-09 Page -L of <br /> GeoEnvironmental, Inc. <br /> 837 Shaw Road- Stockton, California -95215- (209) 487-1006 - Fax (209)467-1116 <br /> Client O.A c Project Manager---., Tests Required <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> ,, 11 tIfo AGE <br /> Project Name —TU- 1114C-5 11�a e� �y �� Client ❑ <br /> I <br /> Sample Type <br /> Sample Location Solid No of C �' Notes <br /> Date Time Water 4 ti <br /> Number Description camp Grab Air Conts <br /> mo L t va rt <br /> ll�J - ZO Ir r{ 2 W <br /> tzL[ ' Noll <br /> MV,4 ' - tIJ U D 17s6 1 <br /> w3- ES �I <br /> it C- �� �ZS �C - <br /> ��_ ZD �� k 3 t� �30� oC <br /> elan is e y ign 4Nr Receivedy ignature Date/Time <br /> 11--N-bq/ yT O �`. <br /> Imquished by (Sign e) Received by (Signature] (� n T Dalel7ime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) 11 �Lll Oata(Time <br /> Dispatched by (Signature) DatelTime Received for Laboratory by Dater ime <br /> e— - i JI_ 3,-3 N <br /> Method of Shipment Laborr Warn <br /> Special Instructions <br /> I hereby outhon=e the performance of the above Indicated work <br /> � � <br />
The URL can be used to link to this page
Your browser does not support the video tag.