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ARCHIVED REPORTS XR0012590
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 XR0012590
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Entry Properties
Last modified
6/20/2019 5:51:30 PM
Creation date
6/20/2019 4:08:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012590
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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$_ y 5 <br /> 'tet <br /> i. TERNATL <br /> TECHNOLOGY ` RIA Control No. 2�r' � <br /> CORPORATIONREQUEST FOR ANALYSIS <br /> C. Con, of No. y <br /> PROJECT NAME �' SS�'��v—Ai"M DATE SAMPLES SHIPPED <br /> PROJECT NUMBER L�UtJ LAB DESTINATION X19 { 10�` <br /> PROFIT CENTER NUMBER j LABORATORY CONTACT J <br /> _ <br /> PROJECT MANAGER 1 J"A �v 71"t SEND LAB REPORT TO <br /> BILL TO _� Cr <br /> DATE REPORT REQUIRED <br /> 'URCHASE ORDER NO. lf,�.� �r PROJECT CONTACT l v�v <br /> 7 r <br /> PROJECT CONTACT PHONE NO. C_�-_�1 '�, Z ��_ h <br /> Sample No. Sample Typp Sample Volume Preservative Requested Testing Program Special Instructions '.+ <br /> 55 - <br /> LQGAJ - �i $ <br /> Tt:'1}} ah &0I��qTL <br /> T t E,oj Ta'X d IV w_ n <br /> -353- t Cc9 Cr �Y� b, <br /> 7UR Rush must be approved by the Laboratory Project Manager.) QC LEVEL: (Levels fI and CI subject to surcharge;project-specific requirements must be <br /> td,=ipasubmitted to lab before beginning work.) <br /> (Subject to rush surcharge.) I II III- <br /> Project Specific s <br /> POSSIBLE HAZARD 10F (Please indicate if sample(s)are hazardous materials andlor suspected to contain high levels Of hazardous substances.) <br /> Non hazard Flammable Skin Irritant <br /> Highly Toxic Other <br /> P, <br /> SAMPLE DISPOSAL:!: ; (Pleaso Specify) r i <br /> ( se indicate disposition of sample following analysis.Lab will charge for packing,shipping,archive and disposal.) <br /> Return to Client Disposal by Lab Archive�_ (Indicate numbei of month J <br /> FOR O LAB USE ONLY , <br /> { Received by DatelTime <br /> WRITE Ocig o' accompanysamphs <br /> , <br /> t:LLC eld c 1 .. .. k _ w 7 i I ,xn io a•. -, <br /> , <br /> { <br /> ,I <br />
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