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ARCHIVED REPORTS_XR0004404
Environmental Health - Public
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3500 - Local Oversight Program
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PR0545486
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ARCHIVED REPORTS_XR0004404
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Entry Properties
Last modified
3/10/2020 5:02:39 PM
Creation date
3/10/2020 3:01:46 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004404
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 /> coD <br /> GeoAnalytical Laboratories, Inc. <br /> 1031 Kansas Ave Phone (209) 572-0900 0 <br /> Modesto, California 9`351 Fax 1#(209) 572-0916 <br /> CHAIN OF CUSTOD1 � y <br /> t4U 'I <br /> Client 60 L1 F !JI0 tb—"ym '6✓-U Tj� --� _—_ Phone <br /> Addiess— ox �' CC to <br /> r _ <br /> Zip- VP <br /> Iv I <br /> PROJECT ID ANALYSIS <br /> No <br /> SAMPLED BY (signature) a <br /> • <br /> camp e ers I / / REMARKS <br /> � iYPe Sample ID <br /> i Date Time c,a, comp a <br /> H I <br /> - <br /> Relin i ed by (signature) pate ime Rceiv 'Adbsigrajul Date I Time <br /> Rehnquishe (signature) Date Time R ived by (S nature) Date Time <br /> Relinquished by (signature) Date Time Received by (signature) Date Time <br /> Relinquished by(signature) Date Time Received by (signature) Date Time <br /> Relinquished by(signature) Date Time Received by (signature) Date Time <br /> Site rime Driving Time i <br /> Start Finish Total Hours Start Finish Total Hours I <br /> E — _ I <br /> Mileage Approved By <br /> II <br /> Garoll Grephice(209)S27-3667 <br />
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