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ARCHIVED REPORTS XR0001336
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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C
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CENTER
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1201
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3500 - Local Oversight Program
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PR0544188
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ARCHIVED REPORTS XR0001336
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Entry Properties
Last modified
2/27/2019 1:49:41 PM
Creation date
2/27/2019 11:32:56 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0001336
RECORD_ID
PR0544188
PE
3526
FACILITY_ID
FA0006698
FACILITY_NAME
FERNANDOS PLACE
STREET_NUMBER
1201
Direction
S
STREET_NAME
CENTER
STREET_TYPE
ST
City
STOCKTON
Zip
95209
APN
14716003
CURRENT_STATUS
02
SITE_LOCATION
1201 S CENTER ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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rttt� t� i tl! ! tw► tt� � � i � � � tll� i <br /> Advanced CHAIN OFF CUSTODY RECORD <br /> GeoEnvlronmental, Inc, DatePage Of 57 <br /> 837 Shaw Road- Stockton California 95215- (209)467-1006- Fax (209)467-1118 <br /> Client Liz(/V Prod Manager <br /> L 1-3 <br /> L� Tests Required <br /> Phone Number <br /> SiL P&L/6, <br /> 5a Iers (Signature Invoice <br /> ProjectName �f '�/ �! AGE <br /> Client ❑ <br /> Sample Location Sample Type No f ' <br /> Number Description Date Time Water Air Solid Copts ; Notes <br /> Comp Grab <br /> 10-396L <br /> 4u5' YO I y <br /> Its I-q3 <br /> elfipuis a rg lure eceive y ignature <br /> �{ 0 telTrme / 7� <br /> {� T z <br /> Relinquishe y (Signature) Received by (Signature) f baterrime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Datefrime <br /> Dispatched by (Signature) Datefrrme Received for Laboratory by Date/Time <br /> S� <br /> Method of Shipment Laborat y Name <br /> Special tnsttuctions ! hereby authorize the per rm nca of the above indicated work <br /> L <br />
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