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ARCHIVED REPORTS_XR0005507
Environmental Health - Public
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EHD Program Facility Records by Street Name
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N
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99 (STATE ROUTE 99)
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14800
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3500 - Local Oversight Program
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PR0545626
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ARCHIVED REPORTS_XR0005507
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Entry Properties
Last modified
11/19/2024 1:50:28 PM
Creation date
4/29/2020 1:40:50 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005507
RECORD_ID
PR0545626
PE
3528
FACILITY_ID
FA0000957
FACILITY_NAME
LATHROP GAS & FOOD MART*
STREET_NUMBER
14800
Direction
S
STREET_NAME
STATE ROUTE 99
STREET_TYPE
RD
City
MANTECA
Zip
95336
APN
19702004
CURRENT_STATUS
02
SITE_LOCATION
14800 S HWY 99 RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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• 680 Chess to Drive• Redwood Cly, CA 94063. 415 364-9600 FAX (4164-9233 <br /> 1 SEQUOIA ANALYTICAL y { } <br /> 4- -0100819 West Striker Ave. • Sacramento, CA 95834 • (916) 921-9600 FAX (916) 921 <br /> CUSTODY '❑ 1900 Bates Ave. Suite LM - Concord, CA 94520 . <br /> CHAIN OF (510) 686-9600 FAX (510) 686-9589 <br /> Company Name: 92h-ter! Project Name: �ij10L'Y lel <br /> 1 33 l�• �'IA2C� '..VP• Billing Address( rf different): <br /> Address: <br /> City: `y9 /,4zA State: Zip Code: <br /> Telephone rOl /! Z Pad FAX#: rr/6 924?— ' / P.O. #: 5 1 1 m <br /> U <br /> Report To: JIM Pr TT/! Sam ler: ,P CC Data: Level A(standard) ❑ Level B ❑ Level C ❑ Level D <br /> Y <br /> C <br /> Turnaround ❑ 10 Working Days orlon Days ❑ 2 - 8 Hours ❑ Drinking Water JAnalyses Re uested (L <br /> Time: ❑ 7 Working DaysorkinclDays L/ H/ZXWaste Water <br /> ❑ 5 Working Days ❑ 24 Hours 'F/9-1'. Other <br /> Cont. V <br /> Client DateTme Matrix #of Sequoia's <br /> Sample I.D. Sampled Desc. Cont. Type Sample # Comments <br /> ' U i� V�ti°Olt' 1 LV q,L cj o <br /> t. N ✓��T t or <br /> 2 t irl�r gb y o $ <br /> U) <br /> 0 <br /> >1 <br /> 3. } <br /> 4_ <br /> 5. <br /> 6. <br /> Ld <br /> 7. 0 <br /> 8. <br /> m <br /> 9. <br /> 10. <br /> Relinquished By: Date: 2t TimeVoOr Ftt:►.Lived By: Date: Time: <br /> r <br /> Relinquished By. Date: Time: Received By: Date: Time: <br /> i <br /> Relinquished By. Date: Time: I ReLuived By Lab: Date: ime: <br />
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