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SR0082895_SSCR
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2600 - Land Use Program
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SR0082895_SSCR
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Entry Properties
Last modified
12/3/2020 2:10:21 PM
Creation date
12/3/2020 9:16:42 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCR
RECORD_ID
SR0082895
PE
2603
STREET_NUMBER
23577
Direction
S
STREET_NAME
MOUNTAIN HOUSE
STREET_TYPE
PKWY
City
MOUNTAIN HOUSE
Zip
95304
APN
20908026
ENTERED_DATE
11/16/2020 12:00:00 AM
SITE_LOCATION
23577 S MOUNTAIN HOUSE PKWY
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\sshih
Tags
EHD - Public
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SunStar <br /> Laboratories, Inc. Chain of Custody Record <br /> PROVIDING QUALITY ANALYTICAL SERVIGEs NATIONWIDE <br /> 25712 Commercentre Drive, Lake Forest, CA 92630 <br /> .949-297-5020 / <br /> Client: T—eeDate: f Page: r Of <br /> Address: Q� �t B L � Project Name: �'► oyi At hA 1400 SQ_ — L Sr <br /> Phone: C1/fp - 701— �� Fax: Collector: _7c�j w M I KAf ct Client Project#: /VA 670 <br /> Project Manager: l b .! � L i Batch#: 9 EDF#: <br /> CU <br /> O <br /> X C N � *k <br /> 0 - <br /> X X X m T x H ! t o <br /> LU Lu <br /> 0 2? :S W 0 a- O O <br /> + M CO :E :EI` U - c6 <br /> Date Sample Containero N 12 � � o o � Q <br /> Sample ID S mpl d Time Type Type 00 00 00 00 w CO w 00 CD Comments/Preservative <br /> 59-7-1 IZVEP q 16°00 50a 1 1 9 r7-Q 14,9 '0 <br /> ( l -, 3 <br /> A ii <br /> Relinquished by: (signature)` C�atme Receiv by: (signature) j �D�/�me� Total#of containers Notes <br /> Chain of Custody seals Yal NA ��s,n bV <br /> Relin shed by: (signature) Date/Time Received by: (signature) Date/Time Seals intact?Y/N/0 <br /> &�50 - � `r/ 1 "11 Received good condition/cold LtP <br /> Relinquished by: (signature) Date/Time Received by: (signature) Date/Time s�� <br /> Turn around time: Sri "'6f} <br /> Sample disposal Instructions: Disposal @$2.00 each Return to client Pickup <br /> COC 160756 <br />
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