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ARCHIVED REPORTS_XR0012692
Environmental Health - Public
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EHD Program Facility Records by Street Name
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F
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F
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5491
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3500 - Local Oversight Program
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PR0545028
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ARCHIVED REPORTS_XR0012692
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Entry Properties
Last modified
12/6/2019 5:54:55 PM
Creation date
12/6/2019 2:59:49 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012692
RECORD_ID
PR0545028
PE
3528
FACILITY_ID
FA0003919
FACILITY_NAME
VAN DE POL ENTERPRISES
STREET_NUMBER
5491
STREET_NAME
F
STREET_TYPE
ST
City
BANTA
Zip
95304
CURRENT_STATUS
02
SITE_LOCATION
5491 F ST
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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� y <br /> DELTA Sample ldentaffcation1Fietd Cham of Custody record <br /> ENVIRONMENTAL CONSULTANTS,INC. <br /> Project: 3,A, f� !` <br /> G" <br /> Shipped by 62 /vu W.o.# <br /> Shipped to: Attention of. <br /> Comments: <br /> Datil ct� Hazardous materials suspected?(yes/no) <br /> POWSample N0.of AnzlyeU <br /> LOQ Field!D At Gate Type Coatakwro Ra <br /> quked <br /> 1 � � <br /> AAw-t 067 Z" � tZ 8 Z <br /> it �c <br /> ,(•tw"-3 1, 1 w-� os'a'�y cors s 8'9 <br /> --F -T <br /> s 1 <br /> T <br /> { <br /> Sampier(s)(signature) <br /> Field 10 Relinquished br:(si nmure) Received by:i nahxe) Dalme Comnm"ft � <br /> i <br /> Sealed For shipment by:(signature) []ate/Fime <br /> Received for Lab by:(signature) � ` � Shipment method: <br /> Date/Time�'�,> .. ��/� Comments <br /> 4 <br /> K. S <br /> Receiving Laboratory:PFease,retu orsailsal s, r BFter nig f°f P rnr f.a <br /> . <br /> i t n .. _ <br /> mss. c <br />
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