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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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SJGOV\wng
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EHD - Public
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_ � � � � � � � � � � � �■ i ttttttttt.w <br /> • �ECORD <br /> CHAIN OF CUSTODA <br /> � Advanced <br /> Date D Y.7-0Page of <br /> GeoEnvironmental, Inc. <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467 1006-Fax(209)467 1118 <br /> Client �, Project Ma ager Tests Required <br /> AUL n�id <br /> Phone Nuber <br /> Samplers (Signature) 4l Invoice <br /> Project Namer� F]rrtlCST Client�L� � <br /> Sample Location Sample Type Solid No of it Nates <br /> Date Time Water <br /> Number Description Comp (arab Air ContS <br /> t s269a <br /> -�� raj �I "rb k 62696 <br /> wu { <br /> �3 r 0 Id 914 " S6269fi <br /> 13= 0 <br /> � a —SB 62697 <br /> I Y U <br /> t3a T 62698 <br /> vo 03130 MW62699 <br /> t I a3f3bf Wl 11A t 62700 <br /> tOi �` W ' 1� Date rr e <br /> e s y �nla (�1i 3'j41�(Relin t ed by ( ) Received by (Signature) Da /Time <br /> Reltnquished by (Signature) Received by Mobile laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) DatelTtme Received or a gratory by Date/Time <br /> Method of Shipment L <br /> Tt 8 RALS OT11� labaC(ory Name <br /> +° �1 <br /> Special instructions GOOD CONDITIONOPIATE l hereby authors th perform noe of the above indicated work <br />
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