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ARCHIVED REPORTS XR0001662
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 XR0001662
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Entry Properties
Last modified
6/14/2019 12:15:40 PM
Creation date
6/14/2019 11:01:21 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0001662
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
Tags
EHD - Public
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.� � fliftlfeifl! rrrrw w w ■� ■w w w � i• � i� � � � <br /> Advanced CHAIN OF CUSTODY RECORD <br /> „'- GeciEnvironmental, Inc. Date Ll"-O)'-C'/Page �-- of <br /> 837 Shaw Road-Stockton, California- 95215 - (209) 467-1006- Fax (209)467-1118 - <br /> Client 'IPA 4 t,o Pro Manager Tests Required <br /> Phone Num, r <br /> Samplers (Slgnatu e) �• Invoice <br /> Project Namect<A �� � �j i� � � , AGE <br /> Client <br /> '1! <br /> Sample Location Sample Type �A L <br /> No of \ <br /> Number Description Date Time Water Solid Notes <br /> (�1 Comp Grab Air ContS <br /> —c2 137-1c -o- <br /> Helin i natur ecewe yigr}alm `� Datefrime <br /> Relinquished by (Signature) Received b l U 7L� <br /> y (Signature) Date/Ti. e <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Dater ime <br /> I <br /> Dispatched by (Signature) Date/TLme Received for Laboratory by Datefri e <br /> Method of Shipment Lt�I Tabora ams <br /> � 60'R-&1(4L— �G <br /> Special Instructions 1 hereby authorize erfor ince of the above indicated work <br />
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