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ARCHIVED REPORTS XR0001620
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 XR0001620
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Entry Properties
Last modified
6/14/2019 1:07:01 PM
Creation date
6/14/2019 10:43:17 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0001620
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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MMMM M l• m I• � I• , <br /> t <br /> 1 0 CHAIN OF CUSTOD ECORD <br /> Advanced <br /> -- "- GeoEnvironmental Inc. Date C 3-13 of <br /> Page � <br /> 4005 North Wilson Way-Stockton,California 95205-(209)467 1006 Fax(249)467-1118 a <br /> Pro ect Man er i Tests Required <br /> Chest <br /> s 7U D-0-7—&A- <br /> Phone Number b <br /> CZO ' b7 —1606 <br /> Samplers (Sign lure) �` (,� C Invoice <br /> AG E-)R�" <br /> Project NameST Client ❑ <br /> r�►� y <br /> Sample Type No of a <br /> Sample Location Date Time Water Solid +`, Notes <br /> Number Description comp arab Air Costs <br /> 62688 <br /> 62699 <br /> 62690 <br /> u1° O�,�o �-� 3 62691 <br /> �3 t2,� k t 62692 <br /> 6A 4�r3o 1rlW - & t '2c} <br /> Y k <br /> { <br /> T 62693 <br /> Re s ign tura ace ve y i lure Dale/Tyne <br /> e <br /> hm;�e <br /> Relinquished b4(9? u'sa�IPO'0, Iv y ( i4natur CJ��t1T� 7� AQat !Time <br /> c000 coNomoH ROPR Relinquished by ( CONTAINS 9eae by Mobile Laboratory for field analysis (Signature) QatelTime <br /> Dispatched by (Signature) Date/Time eceived for Laboratory by Dtaie/Time <br /> 9 r <br /> Labor tory Name <br /> Method of Shipment i C`AV-1P6k 1 <br /> CAL— I hereb orize the pofformaPce of the above indicated work ' <br /> Special Instructions tD 17t�— b'� V,�'\/ <br /> 1 <br /> r i <br /> i <br />
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