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SU0004222
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-0300429
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SU0004222
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Entry Properties
Last modified
5/7/2020 11:30:33 AM
Creation date
9/9/2019 9:09:04 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0004222
PE
2632
FACILITY_NAME
PA-0300429
STREET_NUMBER
23243
Direction
N
STREET_NAME
ROND
STREET_TYPE
RD
City
LODI
ENTERED_DATE
5/14/2004 12:00:00 AM
SITE_LOCATION
23243 N ROND RD
RECEIVED_DATE
8/27/2003 12:00:00 AM
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\R\ROND\23243\PA-0300429\SU0004222\APPL.PDF \MIGRATIONS\R\ROND\23243\PA-0300429\SU0004222\CDD OK.PDF \MIGRATIONS\R\ROND\23243\PA-0300429\SU0004222\EH COND.PDF \MIGRATIONS\R\ROND\23243\PA-0300429\SU0004222\EH PERM.PDF
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EHD - Public
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EDA & L WESTERN LABORATORIES, INC. <br /> AIL 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> Client [� ` o,vJ�Z 7-1A.11 Phone 6& 0 — 1`►" p <br /> Address "� x CC to: <br /> Signature of person authorizing work <br /> under terms stated below' <br /> _ 'Net 30 days. All accounts past due will be subject to interest charg s 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 /> TPROJECT ID No. ANALYSIS <br /> de SNA VE/Z 2 co /. <br /> SAMPLE 'BY: (sig ria): tain- <br /> ers [�[ <br /> /�� /% /\ REMARKS <br /> IT <br /> <.O'"v� Y V <br /> sample <br /> type Sample Location (Q <br /> Date Time Grab comp `7 <br /> x M 5 x MASUR T-,QR A b <br /> 7 <br /> Relin i hed by i lure): Qate Time Received by(signature): Date Time <br /> Relinquished by(signature): Date Time R66eived 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 /> Site Time: Driving Time: <br /> Start: Finish: Total Hours: Start. Finish: Total Hours: <br /> Dedicated Exclusively to Providing Quality Analytical Services <br />
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