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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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f; <br /> rf <br /> ENTERNATIONAL <br /> A/77- <br /> Control No. <br /> A <br /> CHAIN-OF C-STODY RECORD <br /> CO�O�l MOM 197996 <br /> (� pC/C Control No. <br /> PROJECT NAME/NUMBER ��� �� ��"L''� LAO DESTINATION 9 -,A �1 514y\ <br /> SAMPLE TEAM MEMBERS CARRIER/WAYBILL NO. ! <br /> S•Ir+p1e Sample" Data and Tuna Sample container Candition on Receipt Dispoaat <br /> Number Location and DeaCription Calleded Typo Type (Noma IiPld Dale} Re ord No. <br /> 14 to <br /> 14U ; <br /> :S lQ1 <br /> I <br /> 554 -Z � !�4$ <br /> i <br /> Special'cnstractions: <br /> Possible Sample Hazards. <br /> Cf ej--N . X10 �'r. �` y w l r`I yy <br /> 4 <br /> i <br /> SIGNATURES (Name, OmTy, a d'iime) ::,L 7- Cy.Y'j) <br /> I <br /> 1. Relinquished B :� f Z' 3. Relinquished By: <br /> q Y <br /> yt] o Received b <br /> Received By I Y: - — <br /> 2. Relln shed By: A. Relinquished By. <br /> j Received By: <br /> lae rived By:i , <br /> I <br /> - .. WHITE-ToghW snyumptes {'•-_ - ~ <br /> YELLOW•Fict, f 1 <br />
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