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ARCHIVED REPORTS_XR0004403
Environmental Health - Public
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EHD Program Facility Records by Street Name
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3500 - Local Oversight Program
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PR0545486
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ARCHIVED REPORTS_XR0004403
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Entry Properties
Last modified
3/10/2020 4:59:18 PM
Creation date
3/10/2020 3:01:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004403
RECORD_ID
PR0545486
PE
3528
FACILITY_ID
FA0005611
FACILITY_NAME
ROYAL OAKS SAVINGS
STREET_NUMBER
510
Direction
N
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
95336
CURRENT_STATUS
02
SITE_LOCATION
510 N MAIN ST
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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r <br /> G-eoAnalvtical Laboratories, Inc. <br /> CD <br /> 1031 Kdnsas Ave Prone (209) 'iQ i0 0 <br /> llviodcsto, California 95351 >'3r (20 ; 99I <br /> rCHAIN OF CUSTODY <br />(Client Plione <br /> Address _ CC to <br />' — - — — Zip — -- - ------ ' <br /> r PROJECT ID No ANALYSIS, <br /> / <br /> at <br /> on <br /> SAMPLED BY (signature) 1a; <br /> REMARKS <br />�I Date Time Npe <br /> sample to — <br /> GnG <br /> 3rr r a,% , G I I �= r'�7 1 ':7, t <br /> 1 )1'! t91- <br /> I- -� <br /> K,- I Y� Lt,� J"�1Q I I tf� I I <br /> �s I i-q �,��,;� IT IC 1'�J <br /> FF <br /> '- <br /> W <br /> Relinquished by (sc nature) Date Time Received by Dt Time <br /> Reit 4lsned by (signature) Date Tirrip Rece-eed by (signature) r / I Dales lII T-me 1 <br /> Relinquished by (signature) Date Time Receivi cl by (s:gnature) Date i r ie <br /> I Relinquished by (signature) Date Time Received by (signature) Date I Time <br /> I <br /> I <br /> Relinquished by (signature) Date I Time Received by (signature) Date Time <br /> Site Time Driving Time <br /> rt Finish Total Hours Start F nisn Total Hours <br /> Mileage -- —_ <br /> Approved By <br /> Ga mh GngMc-(209)527 3567 <br />
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