My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
ARCHIVED REPORTS_XR0005522
Environmental Health - Public
>
EHD Program Facility Records by Street Name
>
N
>
99 (STATE ROUTE 99)
>
24323
>
3500 - Local Oversight Program
>
PR0544358
>
ARCHIVED REPORTS_XR0005522
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
11/19/2024 1:50:25 PM
Creation date
4/17/2019 3:12:44 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005522
RECORD_ID
PR0544358
PE
3528
FACILITY_ID
FA0021623
FACILITY_NAME
JAHANT FOOD AND FUEL
STREET_NUMBER
24323
Direction
N
STREET_NAME
STATE ROUTE 99
City
ACAMPO
Zip
95220
APN
00516019
CURRENT_STATUS
02
SITE_LOCATION
24323 N HWY 99
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
46
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
W Ron RW (an MR � � ow � 01=0 M-111111T� <br /> 720 Olive drive,Suite D <br /> .�� Davis,CA 95616 <br /> Lab 530 297 4800 <br /> ANALYTICAL LLC Fax 530 297 4803 Lab No 1591A Page I of <br /> Project Manager Phone No <br /> -Toe K g kAa a (s I 3S - 31 S 0 Chain-of-Custody Record and Analysis Request <br /> Company/Address FAX No <br /> t— Far Lab <br /> Rev i r t� lb) 3S'� - }B Analysis Request Use Only <br /> Project Number PO No Project Name �, o o WET(x) <br /> Project Location Sampler Signature rornt (x) p <br /> T4 tit R0,14 Ac4 io, o m m o �, <br /> o <br /> co 01 <br /> Container Method m _ 0 0 .. N N <br /> Sampling (TypelAmount) Preserved Matrix — a a a �+ a <br /> J p m ap Z r <br /> o vyi aoo s ° 2 m m m` m` coa v a p v <br /> Sample ' �,,� g �, �, a � � co <br /> 13 0 -1 1 E U z W 0 ¢ H F e z 0. 0� <br /> Designation Date Time v, x x z 3 m as �, ,. ,. w W — T <br /> SB1 - l � !I (ti 99 9't0 M k 5 X X X X — D ! <br /> SB I IS <br /> SBI is 1060 1 x S X X X <br /> S131 4S 1010 i 1 X I is X X X — 0`f <br /> S 41 - 55 1020 1 k I Is X I X I II - 05 <br /> SBl - 65 HOW 1 x IslX xI - oil <br /> S51 - BO 11m I X 5 XI - 07 <br /> SQA - Gw 1200 X W X X X - (n <br /> D W 1-430 W 9 X X —09 <br /> I IT L- I I I I I I <br /> Relinquished by Date Time Received by Remarks w of tt S1t wpltf Ce;�t4(ha� til, <br /> t►Jlgj)9 IBIS 4'0(t3 <br /> Relinqui tied by Date Time Received by Email address <br /> ❑ doc ❑ As ❑ bd ❑other <br /> Relinquished by Date Time Recgivpd by Laboratory Bill to RO- t 1 t E%Vl ilto y wit K#q l <br /> Distribution White-Lab Yellow-File Pink-Originator U COC fhB(9198) <br />
The URL can be used to link to this page
Your browser does not support the video tag.