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ARCHIVED REPORTS_XR0006491
Environmental Health - Public
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EHD Program Facility Records by Street Name
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Y
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YOSEMITE
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1012
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3500 - Local Oversight Program
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PR0545948
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ARCHIVED REPORTS_XR0006491
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Entry Properties
Last modified
9/29/2020 10:09:27 PM
Creation date
8/5/2020 3:52:52 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006491
RECORD_ID
PR0545948
PE
3528
FACILITY_ID
FA0005159
FACILITY_NAME
FILL-EM FAST
STREET_NUMBER
1012
Direction
W
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
APN
21903024
CURRENT_STATUS
02
SITE_LOCATION
1012 W YOSEMITE AVE
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
Scanner
LSauers
Tags
EHD - Public
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r -_- SunStar Latioratortes, inc -_ Chain of Custody Record E <br /> ( � - <br /> 3002 Dow Ave , Ste 212 <br /> - Tustin, CA 92780 Idl z <br /> - -1-800-781-6777 <br /> _- Cltent % /l V p Date 9--7-3 -�� Page Of <br /> Address _ r CA YZI Protect Name sx- E Z� 5e26(yw— LC9r2 8-7e, <br /> I :- <br /> Phone �r't> _Z _ Fax -56 e,-06'?,5 ._ Collector—A. F,_ _ , __Client Protect# Z7( 3'L. <br /> -- -Protect Manager Sc43t b—J k V" N Batch # Proposal # <br />'— Ln <br /> - - <br /> U <br /> C: <br /> j D <br /> O O <br /> Ix Ir:-:, <br /> '- t!'S r Q 4 4 <br /> N CD !1 CO r r p (D p <br /> CO CO CO <br /> Sample Container a a d < a a a a a 0 °� <br /> Sample 1D Date Sampled Time Type Type w u� w w w w w w w � 0- Comments F <br /> K <br /> - © ° <br /> r a L? <br /> _- Relinquished by (signature) Date I Time y nat D e! imee Total#of containers Notes <br /> ~� �d` 2iZ �` t Chain of Custody seals YININA <br /> by ature Date/TIme Ileceiv Date�e Seals intact?YIN/NA <br /> Received good condition/cold <br /> -_ iinquishe y ature Date I Time eceived b signature) Date I Time <br /> -_ Turn around time r"t <br />` Sample disposal fns s Disposal @$2 00 each Return to client Pickup __ <br />
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