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ARCHIVED REPORTS XR0012589
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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C
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COUNTRY CLUB
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1403
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2900 - Site Mitigation Program
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PR0505513
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ARCHIVED REPORTS XR0012589
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Entry Properties
Last modified
6/20/2019 5:17:57 PM
Creation date
6/20/2019 3:59:58 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012589
RECORD_ID
PR0505513
PE
2950
FACILITY_ID
FA0006438
FACILITY_NAME
United # 5446
STREET_NUMBER
1403
Direction
W
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12323246
CURRENT_STATUS
02
SITE_LOCATION
1403 W COUNTRY CLUB BLVD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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I A <br /> I <br /> MTERNATIONAL <br /> TECEIMMO Y ;. R/A Cantrv!No. co I <br /> CORPORATION CHAIN. -CUSTODY RECORD - l <br /> C/C Control No. 5 0 7 02 i <br /> BPS °1�63Z, nuw <br /> . <br /> PROJECT tdAMElNUMBER � ..,.._..,. LAS DESTINATION 'L�3 �:1 <br /> SAMPLE TEAM MEMBERSVI� <br /> CAPAIEN/'iVAYBILL NO. MV CAW <br /> Sample Sample Date and Time, Sample Cgntalner Condition on Receipt Disposal <br /> Numper, Location end Description Collected <br /> acted, Type Type IMarne and Date) Record No. <br /> 41 <br /> 9J$M0°11S b��ss; <br /> T <br /> 0 925 , <br /> C94 S <br /> Special Instructions: <br /> - � I <br /> #� <br /> Possible Sample Hazards: ' <br /> 1. <br /> SIGNATURES: (N e,C m D e and Time) <br /> I. Relln uished BY � .�.T Car t�� rl �r�';. <br /> q �^ 3. Relinquished By-- <br /> Received <br /> y:Received Sy. Received 6y: <br /> is <br /> 2. P,eiinquished By: 4. Relinquished-By: <br /> Received_ LAV-.,. Received By: K; <br /> a. - TQarx:omY�i��mgley L_ .._.. f U... { __._1 — A --1 _—1 <br /> i <br /> 33i <br /> a _ <br /> s <br />
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