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ARCHIVED REPORTS_XR0002635
Environmental Health - Public
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EHD Program Facility Records by Street Name
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H
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HARLAN
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15600
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3500 - Local Oversight Program
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PR0545273
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ARCHIVED REPORTS_XR0002635
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Entry Properties
Last modified
2/3/2020 6:56:18 PM
Creation date
2/3/2020 11:27:22 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002635
RECORD_ID
PR0545273
PE
3528
FACILITY_ID
FA0000174
FACILITY_NAME
JOES TRAVEL PLAZA
STREET_NUMBER
15600
Direction
S
STREET_NAME
HARLAN
STREET_TYPE
RD
City
LATHROP
Zip
95330
APN
19620079
CURRENT_STATUS
02
SITE_LOCATION
15600 S HARLAN RD
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\sballwahn
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EHD - Public
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SunStar Laboratones, Inc Chain of Custody Record <br /> 3002 Dow Ave, Ste 406 <br /> Tustin, CA 92780 <br /> Phone (714) 5054010 Fax(714) 505-4028 <br /> Client Date _1t 1 1 , 15'b Page Of <br /> ti <br /> Address Location c <br /> 3,0 <br /> Phone 0H 1 °IO Fax,(�I °1� (�`{`{"Z�°I 1 Collector S ClientProtect# <br /> Mana er c Batch# �p -- yS'6 <br /> Project g T'. S Cir �n_7�i 1 --- <br /> O COC <br /> ID <br /> m m <br /> yy yy _ <br /> Cp d lb J d O # <br /> m b ao 0 0 o O Q <br /> F <br /> O tN U <br /> Ca O N N O a o o o # <br /> r CD CD CO O CO CD CD (� W CD FA <br /> Date Sample Container ¢ ¢ Q ¢ ¢ ¢ ¢ ¢ a a 4 0 <br /> Sam le ID Sampled Time Typo Type w w tail w w W tail w w 0. Comments <br /> $ , s t s O� <br /> rt 11, <br /> t <br /> + <br /> SD( c. <br /> p. S 0 VOFs <br /> vo a <br /> GP- 2 S t- c <br /> & Sd« kC- <br /> 2 5 <br /> i NC <br /> Sot k� <br /> Q <br /> Ly— <br /> r SoI <br /> EL—L5-- <br /> TOWN of containers Notes <br /> A Chain of Custody seals Y/N/NA <br /> nqu ed by (signature) a Date l Time Re ive y s re) Dat 1 Tme Seals intact?YMM <br /> 1 le��r Received good conddxWcold <br /> Relinquished by (signature) Date 1 Time Received by (signature) Date/Time Turn around time <br /> Sample disstmcbons Disposal @$2 00 each _ Retum to client Pickup UQ f� _, 49 <br /> � /�� <br /> lI♦ ff_ I_ ( Itl♦ IL <br />
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