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ARCHIVED REPORTS XR0006106
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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1876
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2900 - Site Mitigation Program
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PR0542421
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ARCHIVED REPORTS XR0006106
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Entry Properties
Last modified
6/21/2019 12:30:01 PM
Creation date
6/21/2019 10:33:03 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006106
RECORD_ID
PR0542421
PE
2950
FACILITY_ID
FA0024377
FACILITY_NAME
COUNTRY CLUB BLVD/295950
STREET_NUMBER
1876
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12319101
CURRENT_STATUS
01
SITE_LOCATION
1876 COUNTRY CLUB BLVD
P_LOCATION
01
QC Status
Approved
Scanner
SJGOV\wng
Tags
EHD - Public
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2795 2nd Street, Suite 300 <br /> 1FF Davis,CA 95646 <br /> Lab 530 297 4800 <br /> ANALYTICAL�c� Fax 530.297 4808 Lab No <br /> Protect Contact(Hardcopy or PDF To) Callfomla EDF Report? ❑ Yes- <br /> R Arxs Chain-of-Custody Record and Analysis Request <br /> Compan AddressRaoatrnwrdadbrrtnot m thssecbon <br /> A411 Sampling Company Log Code Analysis Request <br /> l ,A4L-A - <br /> horse No FAX No Global ID: <br /> ax a Z7 T _ <br /> Project Number P 0 No EDF Deii+re b e To(Ema AddreBa) _ 6 <br /> 4, eAl A/ x c <br /> 0 <br /> Project Marne sampler Signature iR <br /> Q m w a NJw 1 <br /> Project Address °° D- = °4'' <br /> Sampling Q Container Preaery Matrlu � L2 ` Q <br /> W w w w <br /> `! x x x <br /> Sample Designation Date time r ° LU <br /> ° m ° ° ° , 'yl <br /> i <br /> Relinquished by 0 to Time Received by Remarks <br /> 14r <br /> Relinquished by Date Time Received by <br /> Relinquished by Date Time Recelved by Laboratory Bill to <br /> LAZ <br /> 7/03 r /p91 .401 <br /> D1arvlbuaon V"Oe Lab Yebow Fde Arnk-Onginarar Formslcoc 121001 f,s <br />
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