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ARCHIVED REPORTS_XR0008578
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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WATERLOO
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2537
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3500 - Local Oversight Program
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PR0545857
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ARCHIVED REPORTS_XR0008578
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Entry Properties
Last modified
7/15/2020 9:01:04 PM
Creation date
7/15/2020 3:02:09 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008578
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
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2795 2nd Street,Suite 300 e, <br /> KIJ6FDavis,CA 95616 <br /> Analytical LLC Lab 530 297 4800 SRG#/Lab No % �/ O % Page tt <br /> Fax 530 297 4802 <br /> Project Contact(Hardcopy or PDF To) California EDF Reports ❑ <br /> reg Chain-of-Custody Record and Analysis Request <br /> Com any I Address Sampling Company Log Code Analysis Request TAT <br /> F)hone# Fax# Global ID a ❑ <br /> acs -Z�bS <br /> o m t2 hr <br /> Pro]ct#�O PO # EDF Delrverab To(Email Address) a c <br /> Rr��V ❑ O <br /> Pr ect Name c c 24 hr <br /> ;1�it1� ,[ L Sampler Signature m Q N a. <br /> w co LU N <br /> f`C y�►4� 1 O C.� p p CA N �n c� <br /> Project A-1dd`re'ss �j Sam li Container Preservative Matrix ® m � < W a i; 4❑8 hr o <br /> 2� 1 W140 1 m m m c`Pi a �a <br /> S�oCk- a co 00 " W m W D <br /> a a > W g° 72 hr <br /> 0 � L W W � � <br /> p m _ w w x <br /> m o i0 U z 3: ► P P w x 0 x x to <br /> Sample Designation Date Time g a c7 z = z a U1 „ -.1 > ate. F 3 1 wk <br /> Int- I$ M IX I Y1 N I I A X, <br /> -aj <br /> r''�W'IB b qr0 II 3e SI X ..oL <br /> Relinquished by Date Time Received by Remarks <br /> UMI 50 <br /> \+~ <br /> Relinquished by Date Time Receiv2g by. <br /> BIII to <br /> Relinquished by Date Time Received by Laboratory r For Lab Use Only Sample Receipt <br /> C • <br /> p Z a 'ar 7�0 Temp°C Initials Date Time Therm ID N cum P,—. <br /> 1 <br /> No <br /> oisrribuNnn WNW Lab,Pink Into <br /> Fin. nmann <br />
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