My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
ARCHIVED REPORTS_XR0008534
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
W
>
WATERLOO
>
2537
>
3500 - Local Oversight Program
>
PR0545857
>
ARCHIVED REPORTS_XR0008534
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
7/15/2020 9:58:30 PM
Creation date
7/15/2020 2:52:39 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008534
RECORD_ID
PR0545857
PE
3528
FACILITY_ID
FA0005147
FACILITY_NAME
E-Z FOOD
STREET_NUMBER
2537
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95205
APN
11914035
CURRENT_STATUS
02
SITE_LOCATION
2537 WATERLOO RD
P_LOCATION
99
P_DISTRICT
001
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.
/
70
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
An cc-r <br /> z uan A i�CA 9=4 (949)281 1022 FAX{9i9',zs1 1225 f l 1 � C • <br /> 1074E OJ SuleA Calan CA 92321 (9D9}370.1867 FAX(� 37D1046 (�cJ <br /> 16525 Shemam Way Sate C-11 Van"CA 92406 (918 779-1844 FAX{818)779-1843 <br /> 9454 GM0 SOL&51s Ur Same 6.1 San oem CA 92123 (4W)5ns-9596 FAX J61 RX(M) CHAIN OF CUSTODY FORM Quote No Page z of '- <br /> 9930 South 5161St Suia&426 Plnano�AX 85044 (480`785-0043 FAX[480)7x6-0851 <br /> Client Name e 1�40�) P O/Project Number �S 05-o?2 X 4�rD- z-�, <br /> Address Ct A -3 Project Name '--:Z <br /> City f s State Zip �W?3 Project Manager <br /> TeiFax S76 - 669 5 �d�r•� <br /> «- �'�- Sampler(s} (signature) �. <br /> FT El F-1 El <br /> Ll <br /> Uxl r <br /> m <br /> r„ d C C r _ <br /> Q C) b C <br /> r> a <br /> (A O w c1 W K UJ ` <br /> .. O ❑ Q .— ❑ Q ❑ m <br /> W a1 °° ❑ W a m w + w <br /> c [Q W co o <br /> (A ❑N ' <br /> m a U f(6 CO N N fl d 111 O 47 ti CD LL1 <br /> M Z m '0 C7 O ❑ . O O N N N m <br /> X W w T m = tQ 00 OD N 00 <br /> m 4) J!t E a 1.0 pp tc, 4n = e6 a Q Q Q N Q g m <br /> its E w > >, o a o E m K d iL U a. d = <br /> Sample!D a co J» 90 a ro O i, w w w + w + <br /> Z-~ / W <br /> A4 to Iq 0( <br /> M W- 10 is Ll <br /> t <br /> RzW a Date/Ttme Received b Date/Time Turnaround Time (check one) <br /> II 69-6 y �� �� / --e ,� Same Day 72 hours <br /> l� <br /> elinqu h9d DatelTime f Re nred by Dateff me 24 Hours 5 Days <br /> 48 Hours Standard <br /> Relinquished b Datefrime Received in L inti Dateffime <br /> r r; <br /> 7 VO Sample Integrity , <br /> Remarks Intact On ice <br /> Note By relinquishing samples to Del Mar Analytical,client agrees to pay for the services requested on this chain of custody form and any additional analyses performed on <br /> this nroiect Pavinent for services is due within 30 dans from the date of the invoice Samole(s)will be disposed of after 30 dans <br />
The URL can be used to link to this page
Your browser does not support the video tag.