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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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KETTLEMAN
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2449
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3500 - Local Oversight Program
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PR0543823
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Last modified
10/22/2018 12:43:14 PM
Creation date
10/22/2018 10:33:05 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0543823
PE
3528
FACILITY_ID
FA0003760
FACILITY_NAME
SUNWEST LIQUORS
STREET_NUMBER
2449
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95242
APN
02741005
CURRENT_STATUS
02
SITE_LOCATION
2449 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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CHAIN OF CUSTODY RECORD gillT <br /> Sherwood 8079 N. Lander Avenue <br /> P.O. Box 937 <br /> Hilmar, California 95324 <br /> abs (209) 667-5258 Attention: Phone: Page Of <br /> 00 CORPORA TION FAX (209) 667-2581 <br /> Job ber P.O.ri Project Name <br /> 71 <br /> Job ber <br /> Samplers:(Signature) Site Address <br /> 1 <br /> SAMPLEe LOCATION DATE TIME NUMBER TYPE SAMPLE <br /> (IDENTIFICATION) (MTH/DAY/YR) (HOUR/MIN) OF (GRAB OR CONTAINERS COMPOSITE MATRIX Q �!i <br /> m' � � � REMARKS <br /> Relinq d By:(Signature r Date/Time Received By:(Signature) Date/Time <br /> /f ICS 2a TURNAROUNDTIME <br /> Relinquished By:(Signatr <br /> ) Date/Time Received By:(Signature) Date/Time 24 HOUR ❑ <br /> 48 HOUR ❑ <br /> elinquished By:(Signature) DatefTime Received By:(Signature) Date/Time 5 DAY ❑ <br /> r� <br /> t <br /> C4 OIBUTION: Original-Accompanies Shipment Canary Copy:Sherwood Pink Copy:Sampler NOTE:Samples are discarded 30 days after results are reported unless other arrangements are made. <br />
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