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ARCHIVED REPORTS XR0000774
Environmental Health - Public
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EHD Program Facility Records by Street Name
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C
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CAMBRIDGE
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16470
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3500 - Local Oversight Program
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PR0544155
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ARCHIVED REPORTS XR0000774
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Entry Properties
Last modified
2/15/2019 5:09:30 PM
Creation date
2/15/2019 2:12:11 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000774
RECORD_ID
PR0544155
PE
3526
FACILITY_ID
FA0000185
FACILITY_NAME
CITY GAS & LIQUOR
STREET_NUMBER
16470
STREET_NAME
CAMBRIDGE
STREET_TYPE
ST
City
LATHROP
Zip
95330
APN
19643032
CURRENT_STATUS
02
SITE_LOCATION
16470 CAMBRIDGE ST
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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i <br /> SEQUOIA ANALYTXCAL 9AMPLI;RECEIPT LOG <br /> CT.TFNT NA1S1E. t DATE Received at l a b: Uldoz <br /> (Drinking wattcr) for <br /> It1rC.]i7C(1'tt]1VT} TIME Ruched id Lab: ao"55 reguletary purposes: yw'; V <br /> '14omconun. c �o . LOGIN DATF,. N 1 (Wastewater)for <br /> - ---- <br /> regulatory purposrs• Y 'riYO' <br /> j a tax.#f t.Ig APPROPRIATE RESPONSE LAD <br /> SAMPLE bWxY. <br /> SA14t1'X•1t 9 11 CIAENT TD DE.SCRl1r"PION MATJ<t1X SAWLED CONDMON(131'G) <br /> 1 Custody Present I asseli , <br /> I <br /> i I1ltacl f Dra — ." <br /> 2 Cho ul-ofolstod IAbscntk <br /> 3 TrafF-jcRepor#s or <br /> l�acknl t 1s1 1'r+csciit A cast <br /> d �Airi�111 Aatlaill I Stir cr <br /> I <br /> t'rescnt 1 sa n – -- <br /> 5 lAubillll <br /> 6 Sample Labels. 1'r t1 Absent <br /> 7 1 ample 1Dg ist Not Listed <br /> _ an rain-of Gintod <br /> S. Saiuplc Condil ton PIM 3rohon;I <br /> I- <br /> 9. DO&I informalion an �- - <br /> custody reports,tralDc <br /> Worts and sample --- <br /> Mali agrW <br /> 10-Sample received within <br /> 110111 111"x- rml N. <br /> H. Proper Prescrvalmm <br /> Used Ikyr NO* <br /> 17 Temp Rec xf Lab r _ <br /> I <br /> (Acceptance range for%amples <br /> reqIlTring tllelmal @sA+1-2 Y�sINn; <br /> *If Ch clod,contact lief act Manager ami attach reeml of resolution. <br /> Sampto Receipt Lou <br /> ReNft <br /> rtrul. r141mo?1111116 1f1? Nana JD <br />
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