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ARCHIVED REPORTS_XR0011601
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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16500
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3500 - Local Oversight Program
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PR0545275
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ARCHIVED REPORTS_XR0011601
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Entry Properties
Last modified
2/3/2020 2:18:46 PM
Creation date
2/3/2020 12:48:20 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0011601
RECORD_ID
PR0545275
PE
3528
FACILITY_ID
FA0005678
FACILITY_NAME
LATHROP SHELL
STREET_NUMBER
16500
Direction
S
STREET_NAME
HARLAN
STREET_TYPE
RD
City
LATHROP
Zip
95330
CURRENT_STATUS
02
SITE_LOCATION
16500 S HARLAN RD
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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xrxzc M-': PIN" - Orru-1-].J -x __ � - �L�L t U ✓V +.i - <br /> ` 9 33305 First Way SouthYYederal Way, WA 98003 <br /> Y Y, <br /> INCORPtIRATER CHAIN OF CUSTODY <br /> IHf ASSURANCE OF OUAIITI ❑ <br /> Novato, CA, 11 Digital Drive, 94949 <br /> Phone: 415 883-6100 Fax: 415 883-2673 <br /> Clrrtsullant's Name: R lv SN 4 Pae of <br /> Address: D t` o_ VO C 9-4/ <br /> Project Contact: li Consultant Project #: i 7D s z - 07 Phone !{ WC4 .74-01rFax#: <br /> Sampled b (print): c .4 t-i I`c&--j Sampler's Signature: <br /> Shipment Method: 'Feat Ex B.P. Site Location ES B.P. Site Location: <br /> us Q�1Le ANALYSIS REQUIRED Sample Condition as Received <br /> TAT: ❑ 24 hr ❑ 48 hr ❑ 72 hr ❑ Standard (10 day) <br /> Temperature' C: <br /> X Cooler N: <br /> it C11Inbound Seal Yes No <br /> Outbound Seat Yes No <br /> Snml7le Description CollLL:llon NintrN Prsv {J of, PACE < m v U <br /> Dnta/Tinlc Soil/Water Con[ Sample II <br /> p 0. a a o¢. _ � � COMMENTS <br /> F- uJ F- W O vii Soho <br /> s - S- Zz <br /> ray / /o ' X <br /> X x y- <br /> 33 <br /> 33 ctS X <br /> 5 - /0- eq Z/io g - <br /> gS IZ 9Z (41.) X- X -X, <br /> f33 <br /> • s- 1,2 11- -D iz .r 9� �E4 q x C o m Pos STP <br /> Relinyuishc'Ay/Affiliation Date Time Accepted by/Affiliation Date Time Additional Comments: <br /> Z'w f5-v� <br />
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