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ARCHIVED REPORTS_XR0005983
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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YOSEMITE
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1434
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3500 - Local Oversight Program
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PR0545950
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ARCHIVED REPORTS_XR0005983
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Entry Properties
Last modified
9/24/2020 12:49:03 AM
Creation date
8/6/2020 10:52:54 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005983
RECORD_ID
PR0545950
PE
3528
FACILITY_ID
FA0003739
FACILITY_NAME
Colonial Energy CE 40134 (DBA Power Mart)
STREET_NUMBER
1434
Direction
W
STREET_NAME
YOSEMITE
STREET_TYPE
Ave
City
Manteca
Zip
95337
CURRENT_STATUS
02
SITE_LOCATION
1434 W Yosemite Ave
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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LSauers
Tags
EHD - Public
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Chain-of-Custody Number <br /> SEACOR Chain-of-Custody Record <br /> Feld Office SOC A"VO-U Q Addition-all documents are attached,and are a part of this Record <br /> Address ��3 3 i{' 7'+ ST' Job Name f f x,L7 01L, <br /> Location <br /> 143 W . Y656'Ai,r v� <br />' � <br /> Project# )Ve Task#l(A)42- Analysis Request <br /> Project Manager U Eb W&-Q- <br /> Laboratory 6)5C6W90 4 N m <br /> Tumaround Time R-b Q y� � �" <br /> c3 > 0 <br /> Sampler's Nametu <br /> X,4 o 50, -S m9 N S <br /> p r °0 vQ Ooo °o mo cao aV m o <br /> Sampler's Signature - a � a o .2 N opo ?N a y a <br /> =� z� _ �°� �.- � w a Comments/ E <br /> U ao ao a 20 ON wo @N ma ow cm U n <br /> Sample ID Date Time Matrix z E-co F-co ¢(o >w _to rn to a(D }-ti10-2 P Instructions z <br /> Z-- r.ou N-L.6 <br /> l 0� <br /> 10 Ss 3 <br /> /oy 1m3 3 <br /> 12-72 <br /> jJ0 � <br /> i <br /> Special I"Ictions/Comments Relmqufshe y Received by Sample Receipt <br /> Sign Sign Total no of containers <br /> Print M)91U / Print y Sellers' Cham of custody seals <br /> Company --54!56°-L- ___ Company fie«eAA ' Rec'd good condition/cold <br /> Time LGA Date 2--!2 Time 9 ate Z-10-9S Conforms to record <br /> R.Q (/TL C �� j1^ Relinquished Received by: <br /> Sign Sign Client <br /> d V Print Print <br /> Client Contact <br /> Company Company <br /> Time Ite Time Date Client Phone <br /> aaooncus�cw.uw <br /> Date 2 Page--L of <br />
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