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ARCHIVED REPORTS XR0001616
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 XR0001616
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Entry Properties
Last modified
6/14/2019 1:06:56 PM
Creation date
6/14/2019 10:41:58 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0001616
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 PF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date Page .1 of 13 <br /> 837 Shaw Road-Stockton, Cal(fornla-95215-(209) 467-1006- Fax (209)467-1118 <br /> I <br /> Client Pro Ma ag <br /> Tests Required <br /> P Number <br /> oa <br /> ers (Signature) invoice <br /> Project Name < <br /> AGE <br /> ❑ <br /> Sample Loca ion Sample Type <br /> Number Description Date Time Water Air Solid No <br /> sl Client <br /> Com Grab <br /> 76373 <br /> I <br /> ©5 If76374 <br /> i <br /> a � .N-� 76375 <br /> r I <br /> 76376 <br /> 76377 <br /> t <br /> { 76378 <br /> Re r s e 19nature) ece ve y gni ure <br /> 10) elTime <br /> Relinquished by (Skgnatur Received by (Signature) <br /> r DatelTlma <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) <br /> DatelTima <br /> Dispatched by (Signature) Date/Time Rece ve for aboratory by <br /> Date ima <br /> Method of Shipment Laboral Nn7 <br /> m <br /> 8peclaV Vnatruotions <br /> I hereby cut ire the par rmancs of the above Indicated work <br />
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