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COACHIWUV (2)
Environmental Health - Public
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2200 - Hazardous Waste Program
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COACHIWUV (2)
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Entry Properties
Last modified
2/8/2022 1:13:56 PM
Creation date
2/8/2022 1:07:11 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
RECORD_ID
COACHIWUV
PE
2200
STREET_NUMBER
1627
STREET_NAME
INDUSTRIAL
STREET_TYPE
DR
City
STOCKTON
Zip
95206
APN
17732008
ENTERED_DATE
10/14/2021 12:00:00 AM
SITE_LOCATION
1627 INDUSTRIAL DR SUITE B
RECEIVED_DATE
10/14/2021 12:00:00 AM
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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SJGOV\ymoreno
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EHD - Public
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Enviro-Chem, Inc. Laboratories Turnaround Time <br />0 Sarre Opt/ <br />1214 E. Lexington Avenue,, ,,--y'r7--11.-i,,,,, <br />-o-er:rours Pomona, CA 91766 0 72 H -,, <br />Tel: (909) 590-5905 Fax: (909) 590-5907 0 1 'Ao 'Stant:lard, ' C MATRIX , 1 No. OF CONTAINIre. NNW TEMPERATURE z <br />0 <br />i:1 <br />w <br />-- • <br /> <br />co <br />I.- <br />r/E <br /> _7) t- VY L.)-Z <br />MisciPO4 <br />Other: <br />CA-DHS ELAP CERTIFICATE #1555 <br />SAMPLE ID LAB ID SAMPLING <br />DATE TIME <br />LL, cc Analysis Required COMMENTS <br />003E- r - \NA-1-&-_. <br /> <br />C t`J 0(1,C X X I X <br />\ itTe'l <br />-- <br />_ <br />Company Name: <br />ENN tizo',441-s-TAL -. Cilerill cm t.. CoQS0,--1- )t-kb <br />Project Contact: . Samptees Signature: , <br />Address: p. 0 _ 12.0x -32_,(c > Tel (:.tic - 1 4 19 - S.c12.- <br />-441 Project Name/ID: <br />Ot4..1Eiv.S - -roil c ./ <br />6) IJEK-ICAA W A-7u_ City/State/Zip: (c."S"ii_iv..1 cp. 32,c_-> Fax/Email: Ckel j . A 1(X2--e dCLI rq- - U:70 <br />Relinquished by: ‘, , _- Received by: C ..‘1:1NY I c Instructions for Sample Storage After Analysis: <br />Received by: & -171P Date _ Relinquished by: 0 Dispose of 0 Return to Client Store (30 Days) <br />0 Other: <br />Relinquished by: Received b Date & <br />Date: <br />CHAIN OF CUSTODY RECORD <br />WHITE WITH SAMPLE • YELLOW TO CLIENT Page <br />
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