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ARCHIVED REPORTS_XR0003822
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_XR0003822
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Entry Properties
Last modified
3/9/2020 1:58:19 PM
Creation date
3/9/2020 10:40:24 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003822
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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r r r� ri rr rr r■ r ■r ■r �r r ■r� r <br /> -- ANALYTICAL REQUEST/SAMPLE CHAIN OF CUSTODY-- LAB TRACKING It ----- ------ <br /> RECORD _L OF I 200 3 PATI;RECIEVED <br /> -- �—�-----� � <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES <br /> 10624 OLIVE AVENUE,OAKDALE,CA 95361 _ 4�7,T <br /> , LAB INVOICE TO�-- n� <br /> � r <br /> OF'F ICE-(209)847-9757 Y, <br /> FAX -(209)1147-7744 PH4 T CONTACT <br /> CALIFORNIA CONTRACTORS LIC13NSE#6573661 CLASS A ENGIIVEERINC <br /> OB# dICE# <br /> liluin '1111 IIIIIIi'Ili li 111111 }t'IIIf 3A Ili dh Illi i li j+i t '1{1111 11'11!!1' a 1#l,11lIIIII II 111!'6',°I'h+`E !I 111'!111!IP'!il 1111111',' '' I I'i l 11!1!1!! i III '; '11.t Id Dill 1 tl LiR ANALYSIS AEQUESTFA <br /> SITE SAMPLING MAP <br /> CLIENT CONSULTANT r ° <br /> SIT$NAME 4PrrQ&rti PROJECT ti y I <br /> ADDRESS CITY ST Cd H O w <br /> SAAMER SIGNATURE. <br /> SHIPPED VIA W ILL# a a6o a m 00 <br /> ANALYSIS BY TURNAROUND TIME DAx � ' w w W <br /> SAMPLE I J 1 DATE HKE CONT4tNW TYPE mArxia 1111!!!!Nl!ll!!li!illp 1111111 1111%!11I11lf illllllll 111111! REMARKS LAB I D. <br /> 1} f_ in Ul Llr <br /> 2) J <br /> 3) I� <br /> 4) ) <br /> 5) <br /> I <br /> 6) <br /> 93 l_ <br /> Io) _ ` <br /> ]3) <br /> l2) 1 <br /> 13) <br /> EAlWPLE5 <br /> Esl�nes r RECEIVED 8Y �;�-^� SAMPLE INTEGRITY/CONDITION <br /> 1 r (SIGNATURE) Y r ti./ o-Z f*It] RECEIVED COLD BcINTACT 1 YES f } NO ( } <br /> RQ.NWISFED e} Ay / 3� R�rvw EI: ) <br /> 6 7/ ! AIR BUBBLES IN V O A 5 1 YES } NO LIN S N <br /> p <br /> lS1GNATUIi� � � % !'}n T ' CUSTODY SEALS INTACT 1 YES (Al <br /> NO 4 I N/A 1 1 <br /> A 1 1 bA rE ertmE <br /> REL4+QlII%Wbn RwElvmBI PRESERVATIVES USED I 11:5 f NO f <br /> I�ICNATIE r (SIGtFATVRE) r TYPE OP PRESE V ) <br /> NOTE Pt VASE ARC IIFvI°T11F SAMPI JS SEitlWM'lI FOR fFiv F'UI 1 iun mm IIMP All C WLD LIM1 SS OTlrl R ARRANC IM MfS ARL NA DI * 111'1 r 131' TAMP I TBI' I)1 P h TRA) <br /> 00 =I3AI1 fA Bf ANK%(O1 f f(-I1 1)IN i I1f 111.1f) 1 8 =E(LI f)BLANKS COI I f(-I I I)1N fill 111 1 I) <br /> PINK FFrI.D(oN wmrp,,l)Flllltti frFIA8 WfTIIti..kMf'IFS wi TFCllt t)( F()1(N198 <br />
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