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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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CLOVER
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835
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3500 - Local Oversight Program
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PR0544565
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Entry Properties
Last modified
6/14/2019 2:09:08 PM
Creation date
6/14/2019 1:57:59 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0544565
PE
3528
FACILITY_ID
FA0025332
FACILITY_NAME
RALPH HAYES AND SON INC
STREET_NUMBER
835
Direction
W
STREET_NAME
CLOVER
STREET_TYPE
RD
City
TRACY
Zip
95376
CURRENT_STATUS
02
SITE_LOCATION
835 W CLOVER RD
QC Status
Approved
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EHD - Public
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I I t t t t I I ' ( t I t t t t t t 1 <br /> CIIAIN-Or-CUSTODY RECORD <br /> Send Rclx)rt and Invoice To: <br /> Terrasearch, Inc. (Environmental) Sheet I Of C-O-C Control No.: E C.5-7 f i/0 I L-/ <br /> 1580 N.Fourth Street Project Name: rl' - <br /> San Jos©,California 95112-4676 Project No.: —1:—: 161-)-7L,�t00 <br /> (408) 453-1180 Samplers: r <br /> Carrier/Airbill No.: <br /> LABORATORY NAME: i'-;o, , .0 &V r►-�,,",�.� �f L.- , Telephone: 4©se - yL, FAX <br /> Address: 17 E �f l7�t'+`'�'f �-�". , P1,74,,77-, . Cit- f%�� Certificate No.: /'70S: Contact: <br /> SIGNATURES (Name, Cc pa y, Date an Timy� r;-./,t� t' C 1-1 /nt c <br /> Relinquished By: -+��� ��-� Received By: I . Nit_ l <br /> REQUEST FOR ANALYSIS <br /> Sample No. Sample Location Date/'Circe Collected Sample Container Preservative REQUESTED ANALYSIS Detection Comment <br /> 'Iylx' 'Iypc/siic Limit <br /> =1? �i9r I, �- , �`'x'� a��r t,;<,- , �; C� ��1� r= <br /> Sy-vt, <br /> SP 4 I <br /> 7 Lf <br /> 5-0 If <br /> r� <br /> 5P - 1 o // Ci r <br /> 5P r /I '� •t L ( ..-�l 5 V H l.! Ill V •.r <br /> While-Terrasearch Project Flle Yellow-Terrasearch Field File Pink-Laboratory Copy <br />
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