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ARCHIVED REPORTS_XR0003789
Environmental Health - Public
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EHD Program Facility Records by Street Name
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L
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LOOMIS
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2969
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3500 - Local Oversight Program
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PR0545428
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ARCHIVED REPORTS_XR0003789
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Entry Properties
Last modified
3/9/2020 12:35:24 PM
Creation date
3/9/2020 10:04:45 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003789
RECORD_ID
PR0545428
PE
3528
FACILITY_ID
FA0005487
FACILITY_NAME
MARCIS DIESEL SERVICE
STREET_NUMBER
2969
STREET_NAME
LOOMIS
STREET_TYPE
RD
City
STOCKTON
Zip
95205
CURRENT_STATUS
02
SITE_LOCATION
2969 LOOMIS RD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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-- ANALYTICAL REQUEST/SAMPY CHAIN OF CUSTODY -- LAB TRACKING <br /> RECORD OF E DATE RECIEVED <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES LAB <br /> 1NvoICE TO c <br /> 10624 OLIVE AVENUE,OAKDALE,CA 95361 ...----1� �' ----�?- -►-�.-fit—--=�1.. 1 i ..-- <br /> OFFICE.(209)8474757 <br /> FAX .(209)847-7744 PH# (f��° =.f..)L;. l Z_2� �NTACT -f--1----------------- ------------------------ <br /> CALTFORNIA CONTRACTORS LICENSE#657366/CLASS"A"ENGINEERING <br /> OB# ------------- INY010E II P a # ----—_----------------------------- <br /> SITE SAMPLING MAP <br /> GAB.ANALYSES REQUESTED <br /> CLIENT j-,j )4,<,c4y CONSUL'T'ANT � � � � � � (Norm <br /> It,Ac <br /> SITE NAME C PROJECT a' ~ <br /> ADDRESS "'1 CITY ` ST a � 0 C <br /> SAMPLER SIGNATURE !"' <br /> O �{ <br /> SHIPPED VIA WAYBILL# C7 A °�° $ $ 4 H <br /> LA <br /> ANALYSIS BY TURNAROUND TWE DAY [~ W w So W W <br /> all SAMPLE I Dar DATE TIME CONTAINERS TYPE ArAT x 1.9'' REMARKS/LAB ID <br /> LI L <br /> 2) fobF <br /> 4) + ; _ � i Q <br /> F) ; w <br /> 7) <br /> 8) _ <br /> 9) <br /> 10) <br /> 11) <br /> 12) <br /> 13) <br /> 14) <br /> 15) <br /> RELINQUIs11FD B! • R> Ivm B1 r r �, f �9 SAMPLE INT GRI /CONDITION <br /> r <br /> (SIONATUREI _ f'/ ���� �� 1-� r RECEIVED COLD&INTACT I YES ) NO ( 1 <br /> t� I)ATE17AiE <br /> REZPNQUIS=65 f ,/; � !�`� RC IV'�D B1 f r AIR BURBLES IN V O A S I YES ( NO (., ) LIN@(S)R <br /> I�r (MNATURE) t ' ` 1 U CUSTODY SEALS INTACT ! IFS f 1 NO( 1 'VA 4 f <br /> A DATe r7LNE <br /> RE'LINQUISIIID Bl / RE IMIVED B1 PRESERVATIVES USED I IFS") NO ( <br /> ! (SIGNATURE) ! TYPE OF PRESERVATIXWS ~ <br /> NOTF PI FASF ARCH IVF'TFIF SAMPLES SURMIITFD FOR THE FALL HO[DING TIMP ALI OWFD UNUSS OTHER ARRANGEMENTS ARE MADE * (M T B F T A M F F T B P D 1 P I' TBA) <br /> B B =BAILLR BI ANkS COLI FCTLD IN 11-11-FIELD F B =I IFI I)BI ANKS 001-1 f( 1J)IN TIlF FTT-D <br /> PINK FOLD(OP) 11HITF&1!'L1(111 TO11B IAITHSAMPIFS 1FIIO1% kFTCR%TO(lWlT%%ITIIReS(ITS D}I TECH( O( FfIkNIyS <br />
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