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ARCHIVED REPORTS_XR0010997
Environmental Health - Public
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EHD Program Facility Records by Street Name
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FILBERT
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3500 - Local Oversight Program
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PR0545039
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ARCHIVED REPORTS_XR0010997
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Entry Properties
Last modified
12/10/2019 2:10:02 PM
Creation date
12/10/2019 11:18:31 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010997
RECORD_ID
PR0545039
PE
3528
FACILITY_ID
FA0010186
FACILITY_NAME
DEL MONTE FOODS PLNT #33 - DISCO WH
STREET_NUMBER
110
Direction
N
STREET_NAME
FILBERT
STREET_TYPE
ST
City
STOCKTON
Zip
95205
APN
15702009
CURRENT_STATUS
02
SITE_LOCATION
110 N FILBERT ST
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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-- ANALYTICAL REQUEST/SAMPLE CHAIN OF CUSTODY— LAB.TRACKING #: ---------------------------- <br /> RECORD OF 3 DATE RELIEVED- --------------------_-.------- <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES IN <br /> INVOICE TO: - 1-xa-_-Ada- - tle_—(- =-n-�.za .--.-.-.-----.--" <br /> 10674 OLIVE AVENUE,OAKDALE,CA.95361 ��- 1� -- .� n�A�.-- }-4�--� ------ 5c'. � <br /> OFFICE-(209)847-8757 y <br /> FAX -(209)847.7744 PH.# �Dj----)�UZ f 67ONTACT: J_-1---------------------- -------------------------- <br /> CALIFORNIA CONTRACTORS LICENSE#657366/CLASS"A"ENGINEERING <br /> OB# ......................INVOICE# --- - -- --P.O.# .........--••--.......................... <br /> Rh <br /> Ii,i!`I, I.;.",iI lla._a,'!'li I it Ililii5o`i,,;�,.,�!,•I I III:I",�!i LII 'll!,rI I I. !I1rII1i.,I I I r1�:j.1 <br /> l I!1' II„!I„L! ,IIIA,, <br /> l LAB.ANALYSIS REQUESD SITE SAMPLINGMAP <br /> (NOB'[f0 <br /> CLIENT: CONSULTANT: LL <br /> SITE NAME: COD <br /> PROJECT. <br /> ADDRESS: CITY: ST.:(' Ea O_ <br /> SAMPLER SIGNATURE: ` d <br /> Am �q <br /> SHIPPED VIA: YBILL#: �� pC x Q a a <br /> e <br /> ANALYSIS BY: TURNAROUND TIME: DAY "1 W w a`"o w w <br /> I€'lII SAMPLE LD-f DATE TIME CONTAINERS TYPE MATRIX II�II�FIIIIII}i illlill'{,;tiili Iila�il llllillil!III'I�I !.III}Illiiill.}}]}Ili REMARKS/LAB.I.D. <br /> I) — D <br /> 2J 6 ..G <br /> 3 y �`� 2/ q <br /> 1 -? <br /> 1 ,6 /�/3-2 <br /> 7.) IQ il 4-7 � <br /> g) - 2 <br /> 3a <br /> 17-I <br /> - $ /x.132 <br /> 31 1*5 <br /> - <br /> F <br /> 1 _ <br /> - D 14 <br /> (p 15.) - <br /> RELNUNJISF®BY: RBEEN D Bn ��/� SAMPLE INTEGRITY I CONDITION <br /> �,� (SIGNATURE) G� RECEIVED COLD h INTACT I YES ) NO{ I <br /> DATE ITIME <br /> RFLlNgJZ tM BY: - �,y` '� �� �'' 'I�WEDBY: AIR BUBBLES IN V.O.A:S /YESNO �LINU.S)4- <br /> fSKINATUM (L/Y/l` f (SIONAT(IRE) CUSTODY SEALS INTACT I YES ( NO f i NIA r <br /> A pATE1TB4E <br /> RET.PIQUISHED BY; RECEIVEDBY: JPRESERVATIVES USED I YES NO ( <br /> V//2 <br /> / (SX)NA7URE -l/' r , _�ff FaVATIVrAill � ji <br /> NOTE PLEASE ARCHIVE THE SAMPLES SUBMITTED FOR THE PULL HOLDING TIME ALLOWED,UNIJ O 9 ARRANGEME ARE MADE. * ON1.T.B.F.,T.A.M.E.,I;.T.B.R_D.LP,ES T.IS.A.) <br /> B.B.=BAILER BLANKS COU.FCTED IN THE FIELD. F.B.=FIELD BLANKS COLLEM-1)IN TI IS FIELD. <br /> PINK•FIELD COPY WHITE&YELLOW-TO LAB,WITII SAMPLES YELLOW-RETURN TOC(.IF:NT WITII RESULTS DF.I..'rcc ii('.if,r_1nkm 91 <br />
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