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Environmental Health - Public
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EHD Program Facility Records by Street Name
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12 (STATE ROUTE 12)
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2900 - Site Mitigation Program
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PR0545716
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Entry Properties
Last modified
11/19/2024 3:48:23 PM
Creation date
6/12/2020 11:20:33 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
WORK PLANS
RECORD_ID
PR0545716
PE
2950
FACILITY_ID
FA0025894
FACILITY_NAME
PROPOSED SHOPPING CENTER
STREET_NUMBER
0
STREET_NAME
STATE ROUTE 12
City
LODI
Zip
95240
CURRENT_STATUS
02
SITE_LOCATION
0 HWY 12
QC Status
Approved
Scanner
LSauers
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EHD - Public
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r <br /> Date: THE TWINING LAYORATORIES,,INC. Pa e <br /> g _Z_of ,. t .: <br /> 2527 Fresno Streei,,Fresno, CA 93721 { <br /> (209) 2t?8-7021 - ...L N <br /> Chain•of•Custody and Analysis Request Record <br /> Project Name: —v4 �� Z� <br /> Project Na;:• ---Project Manager: <br /> U <br /> ampler: Company: Phone: Del.By: <br /> SEND REPORT TO: SAMPLING LOCATION -OR- BILLING (Circle One): EXPECTED TURNAROUND: <br /> Company: oL✓I/?'1 r / 1 / <br /> Company:—Cllr'-.lfI-� ,4.� 1C7' <br /> Add ,: ��� Address: r Routine <br /> r� <br /> f (Specify Time: ) <br /> Contact Name: Contact Name: <br /> Phone: Phone: <br /> COPIES TO: n.-fl <br /> Analysis Request <br /> Lab`' Client Sample Number of <br /> ID - \ ID # p Sample DatelTime Containers <br /> _ Descrytion / Sampled Analysis Requested Per Sample <br /> z <br /> ab Ase only. <br /> Relin.gNlshed 8y ff, tion DatelTime �We_cew�edBy <br /> iliati � <br /> . . . ._ . . . * ' Im 1 . __4C V11 ab E J(i�,:r+ .. - atelt+n:cl <br />
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