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ARCHIVED REPORTS XR0000842
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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C
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CALIFORNIA
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1405
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3500 - Local Oversight Program
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PR0544150
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ARCHIVED REPORTS XR0000842
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Entry Properties
Last modified
2/14/2019 6:42:34 PM
Creation date
2/14/2019 4:00:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000842
RECORD_ID
PR0544150
PE
3528
FACILITY_ID
FA0000306
FACILITY_NAME
EMILS LIQUOR & SPORTS SHOP*
STREET_NUMBER
1405
STREET_NAME
CALIFORNIA
STREET_TYPE
ST
City
ESCALON
Zip
95320
APN
22707031
CURRENT_STATUS
02
SITE_LOCATION
1405 CALIFORNIA ST
P_LOCATION
06
P_DISTRICT
004
QC Status
Approved
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WNg
Tags
EHD - Public
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J Advanced 40 CHAIN OF CUSTOOmORD <br /> Z <br /> GeoEnvironmentai Inc. Date11!1� page of 'Z- <br /> X, <br /> 4005 North Wilson MY-Stockton,California-95205-(209)467-1008-Fax(209)467-11 Is v <br /> )(A6-66 9 <br /> cria Tests Required <br /> nt r �eb�r�- Project Manager c� <br /> � ]1 ' <br /> 601 rfC[LtH rarq <br /> Phone Number <br /> a <br /> AboVe= <br /> SlgnatuSampEers: ( Invoice: <br /> Project Name •f AG~ ® <br /> CH <br /> ara <br /> a <br /> 2 <br /> Sample Location Sample Type c <br /> Date Time No. of ' <br /> p'� ; <br /> Number - Description Water Solid '� Notes <br /> Comp. arab. Air cOntS: /� <br /> .a <br /> t I I <br /> 1 , <br /> nqu a e gn lure .: <br /> eca ve y: gnature <br /> ( Q.ff Dale ime <br /> a rrrqu t d by:{8-9natme) � 30 <br /> r+�fa.�i TA-r <br /> Received by: (Signature) Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for Held analysis:(Slpneture) <br /> • Dale(T1ma <br /> r •Dispatched by: (Signature) f)ate/Tlms eee ved for Laboratory <br /> Dale/Time . <br /> a� Method of Shipment: <br /> Laboratory Nems r _ _ '•. <br /> Special Inatruetiens: Mc <br /> I hereby authorize the perform nee oft a above Indicated work. <br /> VOAS O&G I METALS1 OTHER <br /> GOOD CONDITION PPROPRIATE <br /> -- HEAD SPACE ABSENONTAINERS <br />
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