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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0545308
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Last modified
2/10/2020 7:33:31 PM
Creation date
2/10/2020 4:58:48 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0545308
PE
2959
FACILITY_ID
FA0000932
FACILITY_NAME
DOMINO'S #8588
STREET_NUMBER
305
Direction
S
STREET_NAME
HUTCHINS
STREET_TYPE
ST
City
LODI
Zip
95240
APN
03319020
CURRENT_STATUS
02
SITE_LOCATION
305 S HUTCHINS ST
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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SEQUOIA ANALYTICAL x#680 Chesapeake Drive • Redwood City, CA 94063 • (650) 364-9600 FAX (650) 364-9233 <br /> O 819 Striker Ave., Suite 8 • Sacramento, CA 95834 • (916) 921-9600 FAX (916) 921-0100 <br /> �' CHAIN OF CUSTODY <br /> ❑ 404 N.Wiget Lane • Walnut Creek, CA 94598 • (510) 988-9600 FAX (510) 988-9673 <br /> Company Name: Equil.on Enterprises LLC Project Name: q9 O <br /> Address:Texaco Loc.# 92010140 ,3a5 5 . Billing Address (if different): 108 Cutting Boulevard <br /> City: Ldv 1 State: L' A Zip Code: Richmond, California 94804 <br /> Telephone: (510)236-3541 FAX #: <br /> (510)237-7821 P.O.#: <br /> Report To: 4.1 Sampler: QC Data: ❑ Level D (Standard) ❑ Level C 0 Level B ❑ Level A <br /> Turnaround U10 Working Days O 3 Working Days Q 2-8 Hours ❑Drinking Water V Analyses Requested <br /> Time: ❑ 7 Working Days ❑2 Working Days ❑Waste Water Abe <br /> ❑ 5 Working Days ❑24 Hours ❑ Other 4fi , wti yyw <br /> �q ey ee <br /> K e7�\� • <br /> Sample I.D. SaClient Datmpled Desc. Cont. Type Sample # q'��Matrix 0 of Cont. Sequoia's �\ q�9� �G\�$���y3c�0 Comments <br /> `i► 1 �^ I '/Z8/9q 75;6 W V Y�inzo4b—q <br /> 3. `Z�+1t!x AA5V I'd <br /> % <br /> din4. r144,J-1 7 3 Li"J , Iwo! <br /> +6 + - Sl <br /> �+ a°' .id�Y✓ iF "��.'.N�#a ,:, t` 4y-'5. <br /> P', <br /> y <br /> 6. <br /> 7. ` TACT rt #, k ,. g q; •_ I <br /> co®8. <br /> RE oc "i Vt:i j n <br /> 9. <br /> 10. <br /> Relinquished By: DatedTime//30 Received B 4r/� Date: jTime: <br /> Relinquished By: Date Time: Received �..1 Date:Z— Time <br /> Relinquished By: Dale Received Bq�e Date: / �lo-t Time: Jl{4,y- <br /> = /Cwe ' he [t w 2 // • <br /> Were Samples Received In Good Condition? Yes ❑ No Samples I e? es F3 No Method f Shi ent oe a j <br />
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