My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
COMPLIANCE INFO_2024
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
V
>
VICTOR
>
6318
>
1600 - Food Program
>
PR0548998
>
COMPLIANCE INFO_2024
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
6/5/2024 11:12:29 AM
Creation date
4/17/2024 3:02:03 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2024
RECORD_ID
PR0548998
PE
1608
FACILITY_ID
FA0028107
FACILITY_NAME
SUMMERS SOURDOUGH
STREET_NUMBER
6318
Direction
E
STREET_NAME
VICTOR
STREET_TYPE
RD
City
LODI
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
6318 E VICTOR RD
P_LOCATION
02
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
12
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
Corporate Laboratory(1551) Bay Area Laboratory(2728) <br /> 208 Mason Street,Ukiah CA 95482 262 Rickenbacl' Circle,Livermore CA 94551 Chain of Custody - Work Order <br /> 707.468.0401(phone) <br /> nl„h„ NWv,.a1 I,,h„r md„J i. 707 468.5267(fax) Central Valley Laboratory(2922) Reports and Invoices delivered by email in PDF formal <br /> Mnvw.alpha-labs.com Gientservices(gpalpha-labs.com 9090 Union Park Way#113,Elk Grove CA 95624 <br /> WATERS,SEDIMENTS,SOLIDS North Bay Laboratory(2303) San Diego Laboratory(3065) (�{ <br /> 110 Liberty Street,Petaluma CA 94952 2722 Loker Ave'West,Ste A,Carlsbad CA 92010 Lab No� 1 C Stria Pg l of <br /> Report to Invoice to(if different) Project Information <br /> companSignature below authorizes work under terms stated on reverse side. <br /> y: contact-. Project ID: <br /> V"L CA 9 J 6 Analysis Request TAT TEMP aC <br /> Attn: Email address: <br /> Project No: Standard Ukiah <br /> Address: Address: 10 days <br /> 1p 7 \A C-hy 0 rc� <br /> elk5* �'�v PO Number: E Livermore <br /> Phone/Fax: PhonelFax: m <br /> ���`P-sL ^C)1�9 RUSH: <br /> � 5 days <br /> Email Address: �v, <br /> MCA 1 � ,�C) r�/1 1 48 hours <br /> Field <br /> Elk Grove <br /> Field Sampler-Printed Name 8 'gnature: Container Preservative MatrixO <br /> c) o Other: Petaluma <br /> (V/ M <br /> m 6 ° m o _days <br /> > <br /> E o - O Carlsbad <br /> > ar `-" 3 z' C) m Preapproval <br /> Sample Identification Samplln = U Z <br /> o Zo t co .c 0 — L a z 2 required <br /> Date Time v a C7 1 r°n O t- v U Notes/DDW Source Codes <br /> 2 3'2 x x Y 1 x—___+ s <br /> 2 `-2 x x a' 1 x <br /> P%01%A 4Ux& <br /> -_ -_ <br /> i <br /> Relinquished by Received by Date Time <br /> DDW Write On EDT Transmission? Q Yes Q No <br /> State System Number: <br /> If"Y"please enter the Source Number(s)in the column above <br /> CA Geotracker EDF Report? Q Yes Q No <br /> Global ID: Sampling Company Log Code: <br /> DF to(Email Address): <br /> ravel end SR.Time: Mileage: Mist.SuppNes: <br />
The URL can be used to link to this page
Your browser does not support the video tag.