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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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SJGOV\wng
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EHD - Public
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Advanced CHAIN Of CUSTODY RECORD <br /> - = GeoEnvironmental, Inc. Date 041E Page Z of �- <br /> 837 Shaw Road- Stockton,California-95215-(209)467-1006-Fax (209)467-1118 0j 03 0 <br /> Client � Pro ect ana r <br /> LJ V., Tests Required <br /> Pone um r <br /> 20 L '/©D'� <br /> Samplers (Signature) Nb� Invoice <br /> Project NameW ]� i AGE <br /> [e s\l if LCA �p t Client ❑ <br /> Sample Location Date Sample Type <br /> Time Water Solid No of ,` /I/ Notes <br /> Number Description comp crag: Air Conts <br /> �{ T' HO k4l&Y 0 V3 Z LA � <br /> I i g; A \q-3,?-,> XX AIX <br /> MIX <br /> e inquis e y ig lure <br /> Relinquished by (S gnature) Received by (Signature) Dat (Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by DatelTime <br /> Method of Shipment Laborato ?am* <br /> cie Cc � <br /> Special instructions 1l F i hereby authorize the performance of the above Indicated work <br /> L - <br />
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