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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 Laboratories, Inc Chain of Custody Record <br /> 3002 Dow Ave, Ste 406 <br /> Tustin, CA 92780 , <br /> Phone (714)505-4010 Fax(714) 505-4028 -� <br /> (,alio y� Date D Page Of ' <br /> Client. S ' <br /> Address Location <br /> I <br /> Phone — Fax — 1 Collector —r Client Project# <br /> Project Manager C 92,6 R- J4 !' Batch# <br /> T1 <br /> N <br /> a M in C <br /> 1, -a O O O 0 CD O <br /> 0 N 0 O w r r N � O <br /> OBD Co 0 m w co c 01 W w y <br /> Date Sample Container a d a Q a a a a Q a ° m <br /> Sample ID Sam led Time T e Type w w w w w w iii w a` Comments <br /> 121 <br /> 62-4 WIS 17 1 <br /> X. �� <br /> G — r !v <br /> Total#of containers Notes <br /> 98 .1:Oe Chain of Custody seals YIN/NA <br /> linAquished by (signature) ate 1 Time Ret a by si e) Date/Ti e Seals intact?Yft" <br /> Received good oondibordoold <br /> Relingwshed by (signature) Date 1 Time eceived by (signature) Date 1 Time Turn around time <br /> Sample dispos-1 instructions Disposal @$2 00 each Retum to client _ Pickup /( <br /> \(//►O <br /> i ■ti• � � � t±• ! � � � � it l• � i• � � i• <br />
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