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SR0084478_SSNL
Environmental Health - Public
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2600 - Land Use Program
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SR0084478_SSNL
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Entry Properties
Last modified
12/9/2021 1:30:25 PM
Creation date
12/9/2021 1:22:35 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SR0084478
PE
2602
STREET_NUMBER
32521
Direction
S
STREET_NAME
KOSTER
STREET_TYPE
RD
City
TRACY
Zip
95304
APN
25510026
ENTERED_DATE
11/15/2021 12:00:00 AM
SITE_LOCATION
32521 S KOSTER RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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Tags
EHD - Public
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y ENVIRONMENTAL <br />CHAIN OF CUSTODY <br />AND ANALYSIS REQUEST DOCUMENT <br />Lab Number: TEST DESCRIPTION AND ANALYSES REQUESTED <br />�i�.5(Po3 <br />Client: Live Oak GeoEnvironmental <br />Customer Number: 3016608 t <br />i <br />Address' 407 W. Oak St. ' <br />Lodi, CA 96240 I <br />Phone:(209) 369-0375 Fax:%S� <br />IR <br />Email Address: abbyQlogelodi.com <br />Contact Person: Abby Racco m o <br />Project Name: Lavelle, 32521 S. Koster Rd., Tracy n 3 <br />Purchase Order Number: 8 x <br />p V <br />Quote Number. � � � 0 3 <br />Samplerts): <br />US w <br />Sampling Fee: Pickup Fee: <br />a Tv <br />Compositor Setup Date Time: <br />z <br />Samp I Location Description I Date I Time { t{ V A C <br />Num <br />Sampled Sampled ; r a rn t- : m r� <br />- - <br />0 Travel Blank IO/28%2i I C. 30 G 2 G X <br />•4 <br />1 Domestic Well IO�Zg/IZ(I 10.30 G 4 p P/G P ADW SRC O ., X X <br />� I � <br />1 <br />t ' <br />f a { <br />Remarks Relinquished Date: Time: Rel' bed ate: <br />i1717a14�A(0 <br />1Ate: Time: <br />8�,,5�s <br />Received By: Date: <br />'B°l , <br />Time: <br />nd <br />Corporate Offices & Laboratory <br />853 Corporation Street <br />Santa Paula, CA 93060 <br />TEL: 805/392-2000 <br />t <br />Office & Laboratory <br />563 E. Lindo Avenue <br />Chico, CA 95926 <br />TEL: 5301343-5818 <br />FAX: 805/525-4172 <br />FAX: 209/942.0423 <br />FAX: 530/343.3807 <br />CA NELAP Certification No. 011100A <br />CA ELAP Certification No. 1563 <br />CA ELAP Certification No. 2670 <br />l <br />t <br />'s <br />i1717a14�A(0 <br />Time: <br />Io tc <br />Field Office <br />Visalia, California <br />TEL: 559f734-9473 <br />Mobile: 5591737-2399 <br />FAX: 559/734-8435 <br />1Ate: Time: <br />8�,,5�s <br />Received By: Date: <br />'B°l , <br />Time: <br />nd <br />Corporate Offices & Laboratory <br />853 Corporation Street <br />Santa Paula, CA 93060 <br />TEL: 805/392-2000 <br />Office & Laboratory <br />2500 Stagecoach Road <br />Stockton, CA 95215 <br />TEL: 20 9194 2-0182 <br />Office & Laboratory <br />563 E. Lindo Avenue <br />Chico, CA 95926 <br />TEL: 5301343-5818 <br />FAX: 805/525-4172 <br />FAX: 209/942.0423 <br />FAX: 530/343.3807 <br />CA NELAP Certification No. 011100A <br />CA ELAP Certification No. 1563 <br />CA ELAP Certification No. 2670 <br />Time: <br />Io tc <br />Field Office <br />Visalia, California <br />TEL: 559f734-9473 <br />Mobile: 5591737-2399 <br />FAX: 559/734-8435 <br />
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