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SU0008656 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-0900293
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SU0008656 SSNL
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Entry Properties
Last modified
5/7/2020 11:33:37 AM
Creation date
9/4/2019 6:00:06 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SU0008656
PE
2626
FACILITY_NAME
PA-0900293
STREET_NUMBER
13021
Direction
N
STREET_NAME
ELDERBERRY
STREET_TYPE
CT
City
LODI
APN
05805017
ENTERED_DATE
3/2/2011 12:00:00 AM
SITE_LOCATION
13021 N ELDERBERRY CT
RECEIVED_DATE
3/2/2011 12:00:00 AM
P_DISTRICT
004
QC Status
Approved
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SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\E\ELDERBERRY\13021\PA-0900293\SU0008656\NL STDY.PDF
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EHD - Public
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CHAIN OF C USTODY <br /> '" ENVIRONMENTAL <br /> , AND ANALYSISREQUEST DOCUMENT <br /> Lab Number: TEST DESCRIPTION AND ANALYSES REQUESTED <br /> Client Live Oak GeoEnvirontriental <br /> CSstaner Number: 3016608 <br /> Address 407 W.Oak St. <br /> Lodi,CA 95240 <br /> Phone: (209)369-0375 Farr: (209)369-0377 <br /> Email Addroa: abbyalogelodi.com , <br /> Contact person: Abby Raceo ars B <br /> Nnjeet Name: Christ Lutheran Church,13021 N.Elderberry,Lodi <br /> Pmchuse Order Number, <br /> RAIQuota Number: O^ S <br /> Samplar(s). Jessen Welch G $, ; <br /> g <br /> SmnplinSFee: Pickup Fae: $. ' <br /> z <br /> Compositor Setup Dale: Timo: � <br /> Swell Location Description Date Time <br /> Nam Smnpled Sampled 3 A k P vii 5 ff <br /> 0 Travel Blank_ G 2 G I X <br /> Domestic Well 02 G i G 3 P/G P OW SRC O 4 X X <br /> i <br /> yN <br /> Remarks Min MTima. Ralmquislw d Da e: Time: Rei nqu h d Date T ne: <br /> Retaw y: Date: Time: Received Hy: Date: Time: Romwed By: Dew: Tine: <br /> A4 <br /> C� <br /> Corporate Orecee 6 Laboratory Ofeee 6 Labaralory, Mae 6 Laboratory Field Office <br /> 053 Corpaatlon Street 2500 Stagecoach Road 553 E.Lindo Avenue Vlselia,California <br /> Same Paula,CA 93060 Stockton,0495215 Chico,CA 95926 TEL 55W34-9473 <br /> TEL:806/392-2000 TEL:209/942-0102 TEL:530/543-5816 Mobile:559!737-2399 <br /> FAX 805625.4172 FAX:209/942-0423 FAX 530/343-3807 FAX:559!734.6435 <br /> CA NELAP Cerufleatlon No.01110CA CA ELAP Certifloation No.1563 CA ELAP Certakation No.2670 <br />
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