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SU0004350 SSNL
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2600 - Land Use Program
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PA-0200224
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SU0004350 SSNL
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Entry Properties
Last modified
9/9/2024 11:19:07 AM
Creation date
9/4/2019 10:06:59 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SU0004350
PE
2632
FACILITY_NAME
PA-0200224
STREET_NUMBER
17399
Direction
E
STREET_NAME
AVENA
STREET_TYPE
RD
City
ESCALON
APN
20319006
ENTERED_DATE
5/17/2004 12:00:00 AM
SITE_LOCATION
17399 E AVENA RD
RECEIVED_DATE
6/6/2002 12:00:00 AM
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\A\AVENA\17399\PA-0200224\SU0004350\SS STDY.PDF \MIGRATIONS\A\AVENA\17399\PA-0200224\SU0004350\NL STDY.PDF
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EHD - Public
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VtSTERPT <br /> t .. 3 <br /> !! , 131.1-1i._idland Ave.141 ® Modesto, California X5351 9 Phone 209-5294COo <br />. e k <br /> CHAIN OF CUSTODY <br /> /I <br /> Client t Y ��+ Phone <br /> Address V etj 0 �f <br /> CC to: <br /> Zip <br /> I Signature of person authorizing work —, <br /> under terms stated be <br /> 'Net 30 days. All accounts p ue ill b— bject t tore charges of 1.5% per month <br /> 'Hazardous materials are the property of the client. The client is responsible for proper disposal of hazardous wastes. Clients not <br /> picking up hazardous wastes may be assessed an appropriate fee, <br /> - 4 PROJECT ID ANALYSIS <br /> NO. <br /> Con. <br /> SAMPLED BY; gnatur � taln <br /> ors REMARKS <br /> sample <br /> Date Time roe Sample Localion <br /> z GdO Comp. <br /> r 3 p /r S j�/ ,>:r-- <br /> sa-f <br /> ,/ b sa_Z ' i <br /> f `/ v ,L '� r S2rJ <br /> r/ to z;;l k S <br /> F'� <br /> 3D r: L j <br /> Relinquis oy(signatur r4 b e Time Received by(signature): Date Tin,e <br /> j Relinquished by( ature): ` Date Time Receiv <br /> ed by(signature): Dale Time i <br /> i Relinquished by(signature) Date Time Received by(signature): <br /> Date Time <br /> #R ' <br /> i <br /> Relinquished by(signature): Date Time. Received by(signature): Date Tkme <br /> Relinquished by(signature): Date Time Received by(signature): <br /> bale Time <br /> Site lime: Driving Time: <br /> Stara: Finish:c :. Total Hours: Start; Finish; Total Hours: <br /> Dedicated Exclusively to Providing Quality Analvtical Services <br /> Soil Sample Chain of Custody 1 Analysis <br />
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