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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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EHD - Public
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( � 2 Advanced CHAIN F CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date 4L <br /> P� -- <br /> 837 Shaw Road-Stockton,California-85215-(209)467-1606-Fax (209)467.111$ 0 <br /> L <br /> Prq a erClient <br /> � 1 <br /> Tests Required <br /> Ph N7. r <br /> S ature) Invoice: <br /> AGE Q.. <br /> Project Mame d <br /> Client ❑ <br /> Samplb Type i <br /> Sample Lmation No.tl. <br /> Number Description Date Time Water Air Solid cof�ts. / �. _ j' J Nees <br /> Camp, Grab. <br /> l �{ <br /> T � <br /> Aeif stureAIZ <br /> eCekva y:. �gnalufie LY elTims <br /> r 1`7 ' <br /> A knquished by: (Signature) Race:ived by: (Signature) atalTime <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analytic, (Signature) Date/Time <br /> his arched by: (Slgnaturs RateMme Received for Laboratory by: <br /> p ) �...• Date/Time <br /> Ox <br /> Mo.thnd Of shi manta <br /> P r Lab am j <br /> Special tnetruCtions: E hereby Out fze the pattorrn.ance at the above irtsllceted work, <br /> s <br /> w <br />
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