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ARCHIVED REPORTS XR0006110
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 XR0006110
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Entry Properties
Last modified
6/21/2019 12:37:27 PM
Creation date
6/21/2019 10:40:12 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006110
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
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SJGOV\wng
Tags
EHD - Public
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2795 2nd Street, Suite 300 <br /> IFIDavis,CA 95616 <br /> Lab 530 297 4800 <br /> Fax 530 297 4808 Lab No �2pp-z Page of <br /> Project Contact(Hardcopy or PDF To) Cahfornla EDF Report? U res ❑No <br /> � Chain-of-Custody Record and Analysis Request <br /> CompanyiA ess Reoartrtmendedbut nnt to <br /> 14 Zsalnq Company tog Code F- <br /> � Analysts Request a <br /> Zhone r FAX No lobal LD F. x <br /> r <br /> mber PO No t DFDeIlveratr�Ta(Emglld� � g m <br /> r <br /> 6 d X N X <br /> Prosect Name / Sample ignature ` m S <br /> W n � win <br /> � � IU � n <br /> Project Address o <br /> pi1n9 Container Preservative PAatri9 a F n <br /> C O o <br /> 4J h' N <br /> Sample Desi nation Date Time °z N r ° N o <br /> -13 <br /> LU <br /> 0' <br /> Relinquished by We Time Recelyed by Remarks <br /> I <br /> Relinquished by lime Received b <br /> Relinquished t1y bate Time Rqpeived LryLE�yrdto r- Bill <br /> to <br /> 9 OF I 145- /r061 <br /> D+stributivn "Ite-Lab Perth-Orrgtnator FormstGoc 121001 th9 <br />
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