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SU0002249 SSNL
Environmental Health - Public
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JACOB BRACK
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2600 - Land Use Program
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UP-98-08
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SU0002249 SSNL
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Last modified
5/7/2020 11:29:08 AM
Creation date
9/6/2019 10:28:25 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SU0002249
PE
2626
FACILITY_NAME
UP-98-08
STREET_NUMBER
18667
STREET_NAME
JACOB BRACK
STREET_TYPE
RD
City
LODI
APN
01115012
ENTERED_DATE
10/26/2001 12:00:00 AM
SITE_LOCATION
18667 JACOB BRACK RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\J\JACOB BRACK\18667\UP-98-08\SU0002249\SS STDY.PDF \MIGRATIONS\J\JACOB BRACK\18667\UP-98-08\SU0002249\NL STDY.PDF
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EHD - Public
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i <br /> A L WESTERN LABOR TORIES INC. <br /> U9 <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 a Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> Client C(AJl 0 7"/Ahl, Tp <br /> Phone <br /> L . f �c L <br /> Address �� �`�u -�' -�-- _ CC to: <br /> �21. t (Ji ii Zip <br /> Signature of person authorizing work <br /> under terms stated below' <br /> 4�2i" <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 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 /> PROJECT ID ANALYSIS <br /> of �3 <br /> Con- <br /> SAMPLBY: (sigpafure): tain- �� <br /> `Al -'moi ers hC.t" � REMARKS <br /> sample <br /> type Sample Location <br /> Date Time <br /> 7,7775d C 5 A Al <br /> E <br /> Relinq sh6d by(sig t Qate Time Repeiyed.by(signature): Date Time <br /> Relinquished by(. gnature): Date Time Fle(ieived 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 /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> E <br /> Site Time: Driving Time: <br /> fE Start. Finish: Total Hours. Start: Finish: Total Hours: <br /> I <br /> Dedicated Exclusively to Providing Quality Analytical Services <br />
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