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ARCHIVED REPORTS_XR0008579
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_XR0008579
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Entry Properties
Last modified
10/10/2020 10:15:47 PM
Creation date
7/15/2020 3:02:42 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008579
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 low <br /> KTFF 0 Davis,CA 95616 <br /> I Analytical f_LCLab 5302974900 SRG#!Lab No _L'7`7 tal Page ,� of <br /> Fax 530 297 4602 <br /> Project Contact(Hrdcopy or PDF To) Caldomia EDF Report? Yes ❑No Chain-of-Custody Record and Analysis Request <br /> b' .t <br /> Coomany/AdXressv Sampling Company Log Code Analysis Request TAT <br /> P�Dne# Fax# _ Global ID a ❑ <br /> 8 L 12 hr <br /> - Gt??�'7�t i 1 (� X38—�.31�� � � _ <br /> �' T <br /> Project# P O # EDF Deliverable T ( mad Address) g El 0 <br /> QRS-G4(,fo ,•cllpr. ccu� <br /> 24 hr <br /> Project Name Sam Stj{/��/Jt�r $ a o <br /> V�""r CL5 w v N <br /> iN °ui m o a m ❑ <br /> Project Address / Sampling Container Preservative Matrix ® a °a w u < s 48 hr a` <br /> /27 4V'�t IL o p io W O q! 9p W ( F- <br /> � Cala � � a � m V .Y Y� � W � ❑ <br /> p w w w Y a O 72 hr <br /> w w x LU <br /> om 11 wk <br /> Sample Designation Date Time g (4 ao 0 � z i z � � � � � � � U) o � > � � 3 <br /> 2 <br /> x y22 <br /> Relinquished by Date Time Received by Remarks <br /> IT�i• ! law <br /> Rehnquisrw by Cate Time Received by <br /> Bill to <br /> Relinquished by Date Time Received by Laboratory For Lab Use Only Sample Receipt <br /> f Temp°C Initials Date Time Therm ID# Coaanrrroaerr <br /> Yes 1 No <br /> Dismbutbn White Lab Rnk Onginaior <br /> Rev 6518Q5 <br />
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