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ARCHIVED REPORTS XR0011346
Environmental Health - Public
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EHD Program Facility Records by Street Name
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D
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DURHAM FERRY
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1600
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3500 - Local Oversight Program
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PR0544624
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ARCHIVED REPORTS XR0011346
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Entry Properties
Last modified
7/3/2019 6:31:58 PM
Creation date
7/3/2019 3:54:19 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0011346
RECORD_ID
PR0544624
PE
3526
FACILITY_ID
FA0005206
FACILITY_NAME
GEORGES SERVICE
STREET_NUMBER
1600
Direction
W
STREET_NAME
DURHAM FERRY
STREET_TYPE
RD
City
TRACY
Zip
95376
APN
25510004
CURRENT_STATUS
02
SITE_LOCATION
1600 W DURHAM FERRY RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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C) <br /> ANALYTICAL REQUEST/SAMPLE CHAIN OF CUSTODY-- LAB TRACKING ff <br /> RECORD _L OF 0AL-0 DATE RECIEVFI) <br /> -7 <br /> 09/07/1999 1 AB INVOICE To T1 <br /> �'DEL-TECH GEM 1999090166 q 1� A-, <br /> I TAT Standard ----Poe <br /> 1062A OLIVE AVENUE,OAK <br /> OFFICE-(209)847-8757 D DEL-TECH-SVC )61_)Eq --- ---------------------- <br /> FAX -(209)847-7744 CONTRACTOR Pre-Login 1D# 97014 PH# (- CONTACT ----------------------------- <br /> CALIFORNIA CONTRA IJOB# ------------------INVOICE#----- # _�_----- <br /> 'III iiiat, till LAB ANALYSIS REQUESTED SITE SAMPLING MAP <br /> ft,F <br /> 0 4- MJk4,1- CONSULTANT 6-TI <br /> CLIENT <br /> PROJECT�'srm AME <br /> Cr ST <br /> ADDRESS &M CrTy <br /> SAMPLER SIGNATURE 0 c, q oho �Z <br /> SHIPPED VIA pp AYBILL# <br /> ANALYSIS BY p TURNAROUND TIME DAYS <br /> I 01q In REMARKS ILAB ID <br /> 111111t SAMPLE I P 0-A =DATE TIME CONTAINERS TYPE MATRIX <br /> Fla-R <br /> 23hw X <br /> ) 1 - 1 1 - 1 <br /> - xm!:�- . 1 - <br /> I f 3) YWI11 <br /> — 13-3-7 A <br /> L j 065 <br /> ZO 7) -7 <br /> 4 <br /> 510)-- <br /> -�* om <br /> Lp 12)YVkZ�, G <br /> _�3 13) A r.r. <br /> 9- 14) S51-1 <br /> ac/ 11) E:_Tv6?A-3 I V 6*_11 DA TE, <br /> RELINQUISHM B) PAJE f 11ME RECETVIED 111 SAMPLE INTEGRITY/CONDITION <br /> IM,01�D (SIGNAVPL) RECEIVED COLD&1NTAcr / YES,(.�, NO <br /> DATE ITDAE AIR BURBLES INVOAS / YES ( ) N0 ;ie_1LfNE(S)# __ <br /> L) <br /> RELINQUI%0)H1 <br /> 0 NO 1 5 (MNA-WRE) I CUSTODY SEALS INTACT I 1i F-S to,"'Jo*' I NIA f <br /> WQm1vQ. 11AIE1 IINIL RrMVED DI DATE!TIME PRESERVATIVES T_Q 1 - 0 ( <br /> R-ELINQUMED BI qkl, ,4, 111-- <br /> (S)ONATURL) <br /> fs t= O <br /> ==qQApAW�_ JW <br /> NOTE ULF-Asro- VE THF SAMPLrS SUBSUFFMI)FOR THE FUI L HOLDING TIME ALLOWED UNLESS(OTHER-1 1J)IN IER ARRANLD <br /> S APT MADL * (MTBF TAMI� I' TBL 1)1 PB A) <br /> , <br /> 'BB =E__ -ANKSColl-ECTEDINT]II IFID F B =I'n,_D BLANKS C01 LEC <br /> I1 <br /> PINK FIFLID(OPI WHITER ILILL01"i TOLA113WITH SANIPLES IELLOIA RETURN TO(LIENTIAITH RESULTS tTFCII( 0( MIRM 98 <br />
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