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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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. . .L WESTERN LAMIATPRIES3 INC. <br /> 131:1 Vllobdland Ave. #1 o Modesto, California 85351 Phone:209-529080 <br /> o ,r <br /> CHAIN OF CUSTODY <br /> �G 4✓J� //4/t �t1:' r <br /> V V P l P YN (/�Si�i Y Phone I 0-5 <br /> Clleni — �S <br /> Address 9n31 _ r cC to. •l.�t/ta� �s f�G��. �� <br /> Z i p �✓;lam wL <br /> Signature of person-authonzlrig work d cY f C z D <br /> under t'erms stated belo.vu',_ <br /> 'Net 30 days. All.accoipfs past due.wlll be subject to interest charges of 1.51A per month. . <br /> 'Hazardous materialsrare the property of the client. The client is4esponsible for proper dispbsal of hazardous wastes. Clients not <br /> picking up hazardous Wasies'`may be assessed an appropriate f9p. <br /> PROJECT IDNa ANALYSIS <br /> / tf <br /> of <br /> � 9 ion. <br /> SAMPLED BY: (signatur2) d, taro- <br /> ers �1 . ' R-EMARKS <br /> r ` sample - - <br /> type <br /> 5ample,_Location - - <br /> Date -Time <br /> //o W401 D'.1 . <br /> 5 <br /> !0 <br /> `50 <br /> r/ <br /> '4/ro I-)Q <br /> Fl <br /> t <br /> Aelin Wledyignature}'V Date. Time R e ved y(sign tore) D to Time <br /> r r E <br /> N <br /> .. ,rut.. <br /> n ul ed Date Time <br /> 4, <br /> Relinquished <br /> Relinquished by{sign,, u e z?:,' 7;� 1' Date," Tlrpe , Flecelved by{slgr?ature) Date Time <br /> Relinquished by(signature) Date: Time Received by{signature) s Date Time <br /> 7■keR -Relinquished by{si.gnature)_ � {. s` ' date. TfReceived by Date. Time <br /> Site Time: qtr u ` , Dn m Ti <br /> ?i5 E F <br /> ,� y y r 7 y <br /> Start: Ftilsla h", Total Hours i Start Fln'ish r f„ Tota[Hours: <br /> Wafer'Sa le C'Nil) of Cfastody 1''Ainalysls Appehtl x <br /> �`Dte�lrcated Exclusrve <br /> ly to ,proW. i 9`Q6afi-N AnalyticaI Services <br /> 5 <br />
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