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ARCHIVED REPORTS XR0001627
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 XR0001627
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Entry Properties
Last modified
6/14/2019 12:59:21 PM
Creation date
6/14/2019 10:44:48 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0001627
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 CUS <br /> T014ECURD <br /> - - GeoEnvironmental, lnc. Date IYO Page � of <br /> 837 Shaw Road - Stockton, California- 95215 (209) 467-1006 Fax (209)467 1118 <br /> Client Protect ana er <br /> 'rd Gy �� � Tests Required <br /> Phone Number <br /> ;2ej9 -Y6 7 lbc►� <br /> Sampiers (Signature) Invoice <br /> Protect Name � AGI=�.- <br /> '�S�" 'y i�' IJ -L �'� �` Client ❑ <br /> Sample t ocation Sampeple Ty , <br /> Number Description Date Time Water Sand NO of Q� a� Notes <br /> Comp Grab Air Conts <br /> 4L)7 +! 0 /itiGv 7 o3iYO <br /> t� f�3 ��Ic ►Lt�t C3 i o /v 1 u <br /> Yt' � <br /> UW1O 3 1OJ I I-3/ ,o /Y 41'V <br /> 4t 14aJ 'Y0N-w1fA G_j a 3 /16 <br /> �cw1?13 3j�� Ht I/ 036!0 /35-5 y�-->.L <br /> Win q"d by ( ign re) eceive y ignature <br /> alelTi I <br /> Relrnquished by (Signature) Received by (Signature) / ( DlefT me <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) bate/Time <br /> /rIrl <br /> Dispatched by (Signature) Date/Trme Race ve r Laboratory D e/Time <br /> Method of Shipment � � Laborator e <br /> Special instructions I hereby Ruth the pe or ance of t e above indicated work <br />
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