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ARCHIVED REPORTS XR0001665
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 XR0001665
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Entry Properties
Last modified
6/14/2019 1:02:26 PM
Creation date
6/14/2019 11:02:33 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0001665
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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( Advanced CHAIN PF CUSTOD RECORD <br /> GeciEnvironmental, Inc. Dace -5t6 )q Pageo#? <br /> 837 Shaw Road- Stockton,California-95215-(209)467-1006- Fax(209)467-1118 <br /> Chem` Pro M ager <br /> _ � Tests Required <br /> Samplers (Signature) bbd Invoice <br /> Project Name <br /> AGE <br /> We S C k!�Lo "� Client ❑ <br /> Sample Location —WaterSar ple Type Solid Date TimeNO °t /V Notes <br /> Number Description Comp Grab Air Cortts <br /> x XIK <br /> � A-l_� <br /> o A- <br /> ) 13 DpiSZ <br /> •w vs KW k3Z� <br /> - ax <br /> y Mw VL1 A- 010 k I �( <br /> Refinqilis a ign t o Received y (Signature) Oate/Ti e <br /> Relinquished by (Signature) Received by (Signature) date ime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) TAT_ Datelrime <br /> i <br /> Dispatched by (Signature) Date/Time Received for Laboratory by I 6 "_J �` _ Date/Time <br /> I <br /> Method of Shipment ` h` Laboratory Name CcJ 4-�e t^,, <br /> Special lnsttuctlons k t r`e I hereby authorize the performance of the above Indicated work <br />
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