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SITE HISTORY
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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3500 - Local Oversight Program
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PR0544513
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SITE HISTORY
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Last modified
5/31/2019 4:53:37 PM
Creation date
5/31/2019 4:41:55 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE HISTORY
RECORD_ID
PR0544513
PE
3528
FACILITY_ID
FA0024115
FACILITY_NAME
WEST CLAY PROPERTY
STREET_NUMBER
639
Direction
W
STREET_NAME
CLAY
STREET_TYPE
ST
City
STOCKTON
Zip
95209
APN
14707110
CURRENT_STATUS
02
SITE_LOCATION
639 W CLAY ST
P_LOCATION
01
QC Status
Approved
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EHD - Public
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a� <br /> Advanced CHAIN OF CUSTODY RECORD, <br /> GeoEnvironmental, Inc, r�ac�X8/03 Page <br /> 937 Shaw Road StoafM Caftmla-95215- (209)667-1006-Fax(209)467-1118 r CIDw <br /> 6 <br /> ClientProject M or IN m <br /> OT-50u <br /> Tests Required w <br /> Phone Number <br /> DpV6 m <br /> Salters: (Sl wure) �t irnoice: <br /> ��++ A <br /> Project Name / t f h, m <br /> Client <br /> Sample Location 3afnple Type x <br /> Number Description Dale Time Water Solid No.of Motes <br /> Gomp. Brad. Coos. (U -1 <br /> S2- 2D$p 1 qOb n <br /> D <br /> G) <br /> M <br /> In <br /> O <br /> C] <br /> --I <br /> O <br /> Z <br /> n _11-71 aivfej ` <br /> ` �1� /m1►_ <br /> inquishedby: (8lanawreZ�� yt� I• P-A D3 1 b 3VReae)red by:(Blpttalure) t� <br /> Oat e N <br /> ?elinquiehed by:(Signature) <br /> Received by MoW4 iberetorp iortiatd-Analysis.19tpnarure) <br /> Dete�Tlm• N <br /> Diapalohed <br /> 6y-.(Signature) DaSelTfm• ti <br /> Recalved for Laboratory by; re/Fim• [W <br /> -i n �_ <br /> o Dt�cCL <br /> �D Method of t'shFpment. -}- <br /> L l leb oratory Name T <br /> t7�PX+�i - D <br /> BPeefal tnaGucllorta; � � <br /> W <br /> ► l •by wthori:e rhe pstfonnanea at M, above indleeled work. m <br /> W CIDA <br /> 1 <br /> m <br /> A <br />
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