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3500 - Local Oversight Program
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PR0544465
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Entry Properties
Last modified
5/16/2019 11:54:59 AM
Creation date
5/16/2019 11:30:23 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
WORK PLANS
RECORD_ID
PR0544465
PE
3528
FACILITY_ID
FA0005837
FACILITY_NAME
STEFANOS GASOLINE*
STREET_NUMBER
1419
Direction
E
STREET_NAME
CHARTER
STREET_TYPE
WAY
City
STOCKTON
Zip
95205
APN
15137016
CURRENT_STATUS
02
SITE_LOCATION
1419 E CHARTER WAY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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SJGOV\wng
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EHD - Public
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Advanced CHAIN F USTODY R CO <br /> GeoEnvironmenta.t, Inc. ` � � Page <br /> ;;:✓ 637 Shaw mead-StocRton, California-96215-(209)467-1006-Fax(209)467-1118 <br /> Client ,4Pro'1.311Manager Tests Required <br /> PVneNT <br /> t�er <br /> 1&7 <br /> Sa s: { ' nature) Invoice: <br /> Project Name k � � AGE <br /> Cflerrt� <br /> Sample Type Y <br /> Sample Location No . et / <br /> Number Descri tion bate Time Water Solid Notes <br /> P Comp, drab. ,t1ir Ct3ntS, <br /> elsnUr a y: n re A"eivad by: synature D (rime 1 ' <br /> Relinquished b :(Signature Received by: (Signature) Date(fime \ <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field anatysis:(Signature) Datemme <br /> Dispatched by:(Signature) DatefTime Received r r logy by: s atefTima <br /> Method at$hipmenL Lab roto a <br /> Special Instructioris: I hereby authorize the parlor ae of t above I icaled work. <br />
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