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SR0082278_SSNL
Environmental Health - Public
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2600 - Land Use Program
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SR0082278_SSNL
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Entry Properties
Last modified
2/25/2021 8:42:33 AM
Creation date
7/29/2020 2:35:09 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SR0082278
PE
2602
FACILITY_NAME
23811 S JACKTONE RD
STREET_NUMBER
23811
Direction
S
STREET_NAME
JACK TONE
STREET_TYPE
RD
City
RIPON
Zip
95366
APN
22817034
ENTERED_DATE
7/2/2020 12:00:00 AM
SITE_LOCATION
23811 S JACK TONE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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CHAIN OF CUSTODY <br /> g ENVIRONMENTAL AND ANALYSIS REQUEST DOCUMENT <br /> Lab TEST DESCRIPTION AND ANALYSES REQUESTED <br /> 63 � <br /> Client: Live Oak GeoEnvironmental <br /> Customer Number: 3016608 <br /> Address' 407 W. Oak St. <br /> Lodi, CA 96240 <br /> Phone. (209)369-0375 Fax: F <br /> Email Ad&cs,: abby@logelodi.com , a <br /> Comao Person: Abby Racco o 8 <br /> Project Name:McIntosh, 23811 S.Jack Tone, Ripon,CA 11 v U <br /> a <br /> Purchase orderNumber: <br /> a <br /> Quote Ntunber. a 5 $ O <br /> Sampler(s): e? a a 9 P- ^'R <br /> f'- z <br /> O O m b <br /> Sampling Fee: Pickup Fee: zw <br /> S to s n d <br /> z LV <br /> Compositor Setup Date: Time: a <br /> Samp I Location Description ( Date I Time rr ty{ { i A <br /> Num I Sampled Sampled M z r a to t- rR rB nt h a <br /> -- <br /> 0 Travel Blank L,-15-20 i 1,2 v G 2 G X <br /> 1 Domestic Well G-6'2A 1d', °� G j 3 P/G P DW SRC O X X <br /> s,. <br /> Remarks Relinquished Date: Time: Relinquished Date: Time: Relinquished D c: Time: <br /> Received By: Date: Time: Rec iv d By: Date: Time: e' to By: Date: Time: <br /> AL <br /> Corporate Offices&Laboratory O r &'Gboratorf Office 8 Laboratory U Field Office <br /> 853 Corporation Street 2500IStagecoach Road 563 E.Undo Avenue Visalia,California <br /> Santa Paula,CA 93060 Stockton,CA 95215 Chico,CA 95926 TEL:5591734-9473 <br /> TEL:805!392-2000 TEL:2091942-0182 TEL:530/343-5818 Mobile:559/737-2399 <br /> FAX:8 0 515254 1 7 2 FAX:209/942-0423 FAX:530/343-3807 FAX:5591734.8435 <br /> CA NELAP Certification No.01110CA CA ELAP Certification No.1563 CA ELAP Certification No.2670 <br />
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