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ARCHIVED REPORTS XR0001611
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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C
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CLAY
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639
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3500 - Local Oversight Program
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PR0544513
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ARCHIVED REPORTS XR0001611
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Entry Properties
Last modified
6/14/2019 1:21:55 PM
Creation date
6/14/2019 10:39:09 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0001611
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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SJGOV\wng
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EHD - Public
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( Advanced CHAIN OF PUSTODY RECORD <br /> GeoEnvironmental, Inc. DateS G� Page �. <br /> 837 Shaw Road-Stockton, California-95215-(209)467-1006- Fax(209)467-1118 <br /> of <br /> car <br /> Client Pr M a r <br /> Tests Required <br /> P)Lwne.h umber <br /> am (S ature) Invoice <br /> Project Name AGS <br /> Client <br /> SampleLocation Sample Type <br /> No of <br /> Number Description Date Time Water Air Solid Conts Notes <br /> Comp Grab <br /> 74,, j�2z IN471- <br /> e in a ignature) ece ve y ignature <br /> q ie/Time,�� <br /> Relin uished by (Signature <br /> i Rehnqu�she ',zSlg+►atta <br /> �rAPNrja! y <br /> ate/Tim <br /> tory for field analysis (Signature) <br /> o <br /> 'CTDR}N -I',! DatelTime�r� C <br /> Dispatched ,:r -,- IYfn,t'rMh') A Date/Time Received for Laboratory by e <br /> Dat /Time <br /> Method of Shipment l�� <br /> aboratory a c-- <br /> Special instructions I hereby orize per ormance of the above indicated wont <br /> S ti <br />
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