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ARCHIVED REPORTS XR0000752
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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B
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BEVERLY
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104
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2900 - Site Mitigation Program
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PR0540667
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ARCHIVED REPORTS XR0000752
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Entry Properties
Last modified
2/8/2019 10:10:14 AM
Creation date
2/8/2019 9:02:48 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000752
RECORD_ID
PR0540667
PE
2960
FACILITY_ID
FA0023252
FACILITY_NAME
WELDON CHURCH PROPERTY
STREET_NUMBER
104
Direction
W
STREET_NAME
BEVERLY
STREET_TYPE
PL
City
TRACY
Zip
95376
CURRENT_STATUS
01
SITE_LOCATION
104 W BEVERLY PL
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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( Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. [late Page z of Z- <br /> 837 <br /> 837 Shaw Road- Stockton, California- 95215 -(209) 467-1006 - Fax (209)467-1118 <br /> Client Project Manager <br /> CvELDarI! Tests Required <br /> At+L zoa;dxj <br /> Phone Number <br /> S6o ro <br /> lXJ Samplers: (Signature) Invoice: <br /> Project Name W Al C/L/44C,4/ AGE <br /> Client ❑ <br /> Sample Location SampWJ115e <br /> No <br /> Date Time Water Solid . of <br /> Notes <br /> Number Description comp. Grab. Air Conts• <br /> Relinquished y: ( nature) Race ve y: ignature Date/Time <br /> S ax l <br /> Relinquished by: (Signature) nature <br /> { g ) ter_ Date/Time <br /> Relin 4 to ddrr,,,,u �r_ He Laboratory for field anaiysia: (Signature) Daterfime <br /> Dispa )mow ?Mfi DatelTime Ifleteived for kabor ry D e/Time <br /> 3D o2 /.3S <br /> Method of Shipment: Llboratory Name <br /> C- C14 B�G� <br /> Speciat lnsttuctiona; l hereby a ho ize th performance of the above indicated work. <br />
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