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COMPLIANCE INFO_2013-2019
Environmental Health - Public
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0538015
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COMPLIANCE INFO_2013-2019
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Entry Properties
Last modified
5/14/2021 8:19:16 AM
Creation date
12/7/2018 9:22:56 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2013-2019
RECORD_ID
PR0538015
PE
1608
FACILITY_ID
FA0021951
FACILITY_NAME
BUFFALO BAKING CO
STREET_NUMBER
4543
Direction
E
STREET_NAME
BALSAM
STREET_TYPE
DR
City
STOCKTON
Zip
95212
APN
08656030
CURRENT_STATUS
01
SITE_LOCATION
4543 E BALSAM DR
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
JCastaneda
Supplemental fields
FilePath
\MIGRATIONS\B\BALSAM\4535\PR0538015\COMPLIANCE.PDF
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EHD - Public
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_ CHAIN OF CUSTODY <br /> ENVIR• www.fglinc.com AND ANALYSIS REQUESTDOCUMENT <br /> Analytical Chemists ar <br /> cram: Patti Lynn Drake Lab Number: TEST DESCRIPTION AND ANALYSES REQUESTED <br /> Customer Number: 3017297 <br /> Address: 4642 Mosher Dr. <br /> Stockton, CA 95212 <br /> Phone: (209)751-9157 Fax: 12 <br /> 12 3 <br /> Email Address: pdrake@deltacollege.edu <br /> Contact Person: Patti Lynn Drake v <br /> Project Name: Buffalo Baking Co. d�c <br /> Purchase Order Number: <br /> `m a <br /> Quote Number: L7 3 b LL !_,ffi <br /> U 3y a O $tn <br /> Rush Matyss: E] 5 Day E]4 Day[—]3 Day 2 Day E]24 hour <br /> Rush pre-approval by tab(initals): <br /> Electronic Data Transfer: No State Client Other: �+ A K a <br /> o <br /> I � S m <br /> O <br /> Sampler(s): <br /> 0 <br /> c gE v € g $ 2 <br /> E <br /> E Z S y m <br /> r0 <br /> N V <br /> Sampling Fee: Pickup Fee: <br /> 5 yYQ3 <br /> Compositor Setup Dale: Time: <br /> Samp Location Description DateTone _ E <br /> Num Si led Sampled o <br /> 1 Well ')l i.�Ih (.a• , G DW Sm 0 1 1 1 <br /> FF <br /> -F F_ I ---- --- 7 <br /> ;E P <br /> �uyhed F=777- <br /> Remarks Re)irr'qyh¢d Date: Time: RetinquiTime: Rchnqus Date: Time: <br /> y/. - �lf flit; ted <br /> Rec iv /te: Tine: Race Tune: ceived By Datc: Time: <br /> 14 <br /> Corporate Offices&Laboratory Office&Laboratory Office&Laboratory Office&Laboratory Offiea&Laboratory <br /> 853 Corporation Street 2500 Stagecoach Road 563 E.Lindo Avenue 3442 Empresa Dme,Suite D 9415 W.Goshen Avenue <br /> ' Santa Paula,CA 93060 Stockton,CA 95215 Chico,CA 95926 San Luis Obispo,CA 93401 Visalia,CA 93291 <br /> TEL.(805)392-2000 TEL (209)942-0182 TEL:(530)343-5818 TEL (805)783-2940 TEL(559)7349473 <br /> Env FAX,(805)525-4172 1 All FAX,(805)392-2063 FAX (209)942-0423 FAX:(530)343-3807 FAX (805)783-2912 FAX:(559)7348435 <br /> CA ELAP Certification No.1573 CA ELAP Certification No.1563 CA ELAP Certification No.2670 CA ELAP Certification No.2775 CA ELAP Certification No.2810 <br />
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