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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
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EHD - Public
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CHAIN OF CUSTODY RECORD Bill To: o <br /> Sherwood 8071 N. Lander Avenue <br /> al <br /> P.O. Box 937 <br /> L�b5 Hilmar, California 95324 <br /> (209) 667-5258 Attention: Phone: Page of <br /> C O R P O R A T I O N FAX (209) 667-2581 <br /> Job 50, <br /> er P.O.p Project flame � <br /> Samplers:(Signature) Site Address <br /> TYPE <br /> SAMPLE LOCATION DATE TIME NUMBER (GRAB OR SAMPLE <br /> (IDENTIFICATION) (MTH/DAYNR) (HOURIMIN) <br /> CONTAINERS COMPOSITE) MATRIX lzl* � ,�Q�,`� REMARKS <br /> P D' a G a, x x_ <br /> 1 <br /> Relinjuis ed By; ign t re Date/Time Received By:(Signature) Date/Ti e <br /> TURNAROUND TIME <br /> Flle mquish@ By.(Si a ure) - Dale ime Received By:(Signature) ate/Time 24 HOUR ❑ <br /> 48 HOUR ❑ <br /> Relinquished By:(Signature) Date/Time Received By:(Signature) Date/Time 5 DAY ❑ <br />�J <br /> illSt.RIBUTION: 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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