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SR0056541 SSNL
Environmental Health - Public
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2600 - Land Use Program
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SR0056541 SSNL
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Entry Properties
Last modified
1/7/2020 1:16:25 PM
Creation date
9/4/2019 10:11:36 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SR0056541
PE
2602
FACILITY_NAME
BULL FROG MARINA
STREET_NUMBER
17247
STREET_NAME
BACON ISLAND
STREET_TYPE
RD
City
STOCKTON
Zip
95219
APN
12917013
ENTERED_DATE
2/17/2009 12:00:00 AM
SITE_LOCATION
17247 BACON ISLAND RD
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\sballwahn
Supplemental fields
FilePath
\MIGRATIONS\B\BACON ISLAND\17247\NL STDY.PDF
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EHD - Public
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1 <br /> A & I� MESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 * Modesto, California 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> E <br /> � 1 <br /> Client. +"tESA) E e621111V -Ti,N[_ _ Phone <br /> Address p d 7 CC to: i <br /> zip q53�? — <br /> I <br /> Signature of person authorizing work <br /> under terms stated below' <br /> 'Net 30 days. All accounts past due will be subject to interest charges of 1.5% per month. <br /> `Hazardous materials are the property of thelclient. The client is responsible for proper disposal of hazardous wastes. Clients not <br /> picking up hazardous wastes may be assessed an appropriate fee. <br /> PROJECT ID ` No ANALYSIS 4 <br /> ,8U4 LF2aC <br /> Con- <br /> SAMPL BY: (3' fain tura): � ars Lr v� � 4/ <br /> REMARKS <br /> sample <br /> type Sample Location <br /> Date Time c.ecoma. . <br /> �S /! 0 X WE r eaAt !fe`.AAl0 D x X X X K X WE LJ, 5A M PI-F-0 <br /> 'I m F p ,Ar V 4c _ or 0P <br /> Y <br /> , <br /> Rived�b�y(sign <br /> / tuP.r_aG):� Date1�7Tii mZeReli had Sure): qy 7 <br /> Time <br /> Relinquished by(signature): i Date Time R eived by(signature): Date Time <br /> Relinquished by(signature): " Date Time Received by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> l <br /> Relinquished by(signature): i Date Time Received by(signature): Date Time <br /> Site Time: Driving Time: <br /> Start: Finish: Total Hours: Start: Finish: Total Hours: <br /> r <br /> Dedicated ExClusrvely to Providing Quality Analytical Services <br /> � �I <br />
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