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SR0081592 SSNL
Environmental Health - Public
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2600 - Land Use Program
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SR0081592 SSNL
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Entry Properties
Last modified
2/6/2020 11:09:56 AM
Creation date
2/6/2020 9:25:34 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SR0081592
PE
2602
FACILITY_NAME
BELLA GARDENS WINE CELLAR
STREET_NUMBER
23563
Direction
S
STREET_NAME
MANTECA
STREET_TYPE
RD
City
MANTECA
Zip
95337
APN
22611046
ENTERED_DATE
1/2/2020 12:00:00 AM
SITE_LOCATION
23563 S MANTECA RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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p CHAIN OF CUSTODY <br /> EnVIRONMEnTAL <br /> AND ANALYSIS REQUEST DOCUMENT <br /> Lab Number: TEST DESCRIPTION AND ANALYSES REQUESTED <br /> cllent: Live Oak GeoEnvironmental <br /> i i 3 <br /> ;Customer Number: 3016608 ! Y I t I t <br /> 'Address: <br /> 1 407 W. Oak St. I 1 <br /> 3 Lodi, CA 96240 <br /> f <br /> Phone: (209)369-0375 <br /> `Email Address: abby@logelodi.Com <br /> Contact Person: Abby RaccO <br /> Project Name: Roddan,23601 S. Manteca Rd., Manteca <br /> : IR <br /> Purchase Order Number: Oft <br /> Quote Number. L ' <br /> c 5 <br /> Sampler(s): i$ g I i i l <br /> y2 z <br /> • IU' .� Z z I f 11 l <br /> ;Sampling Fee: Pickup Fee: g y ' y ^x i i I ! i <br /> I Compositor Setup Date: Time: _ To N 1 u •3 i ? i i 1 t = E ) <br /> � � i i <br /> Samp I Location Description I Date I Time `v i x P I I 1— <br /> Num Sampled Sampled <br /> _ ;--.. y _ . <br /> 0 Travel Blank 9*10 1 G 2 G X <br /> 1 Domestic Well •i s-►•r1 9-10 G 3 PIG P 5DW; SRC O 4 X X v <br /> , <br /> I <br /> Remarks Re6n hed Date: Time: wishedDat : Time: lin 'h Date: Time: <br /> 7 Day RUSH <br /> `l/`� -1l•ia 103,0 �7 /7v�D <br /> ed By: ate:Time: Received By: Date: Time: e x: te: Time: <br /> 7 j 0117 /06c) ��y�17 i7 <br /> Corporate Offices&Laboratory Office&Laboratory Office&Laboratory Field Office <br /> 853 Corporation Street 2500 Stagecoach Road 583 E.Undo Avenue Visalia,California <br /> Santa Paul",CA 93080 Stockton,CA 95215 Chloo,CA 95928 TEL:5591734-9473 <br /> TEL:805/392.2000 TEL:2091942-0182 TEL:5301343-5818 Mobile:5591737.2399 <br /> FAX:805/525.4172 FAX:2091942-0423 FAX:5301343-3807 FAX:559f734-8435 <br /> CA NELAP Certification No.01110CA CA ELAP Certification No.1563 CA ELAP Certification No.2670 <br />
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