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3500 - Local Oversight Program
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PR0544476
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Entry Properties
Last modified
5/17/2019 3:43:03 PM
Creation date
5/17/2019 3:37:50 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
WORK PLANS
RECORD_ID
PR0544476
PE
3528
FACILITY_ID
FA0007904
FACILITY_NAME
HENRY HANSEN PROPERTY
STREET_NUMBER
200
Direction
S
STREET_NAME
CHEROKEE
STREET_TYPE
LN
City
LODI
Zip
95240
CURRENT_STATUS
02
SITE_LOCATION
200 S CHEROKEE LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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. ,. GeoAnalytical Laboratories, Inc. <br /> Lal) Report # J Z6�— 1� <br /> 1405 Kansas Avenue Phone(209) 572-0900 ` <br /> Oti <br /> Modeslo,CA 95351 FAX(209) 572-0916 <br /> +J <br /> PhOnc: <br /> Client: �w c L2,6'4CHAIN OF CUSTODY fax: <br /> Addres. To: ` v <br /> �`�1�-L= � . _ Zip ` �1� <br /> Project In <br /> r �. <br /> (I'rillt Name} �•l1� , ,� .. <br /> Sampled BY <br /> (Signature) (�13i11i1i11C1' o �� \ <br /> LA A10 a !✓! U �4 �cLr Lab II) It <br /> Salnple type <br /> Unlc 'Time .'autlllc ll) Type Size r <br /> 04a6 Comp 61nu1R <br /> z 98 I:z3 �- Sae z /z ! k _Y1 X <br /> Remarks <br /> Rc Inquls ICL )y ('1*nature) )alc 'nuc e c ,y (Signal it D.. iw�c <br /> Rclin uisf )y (Signatf Date '1� Received by (Signature) , Date Time <br /> Relinquished by (Signature) Date Time Received At Uboralory by(Signaturc) Date Time <br /> Site"lime; Driving"Time: Total Hours <br /> Start: t ; 7 3 Finish: L4 3, Tolal !lours: Z20 Slaw Site Arrival: x2= <br /> Milrnnl* Al�[woved I�y_IeAU'f� <br />
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