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ARCHIVED REPORTS XR0006113
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 XR0006113
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Entry Properties
Last modified
6/21/2019 12:44:54 PM
Creation date
6/21/2019 10:43:33 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006113
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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T <br />` 2795 2nd Street, Suite 300 <br /> . � Davis,CA 95616 <br /> Lab 530 297 4800 <br /> ANALYTICAL <br /> LLC Fax 530 297 4808 Lab No y0 Page_/ of_/ <br /> Project Contact(Hardcopy or PDF To) California EDF Reports ya5 ❑No <br /> L�. •� n Chain-of-Custody Record and Analysis Request <br /> Company/Address �f/GC 922Mnpgdobutnot m tietssec6aa <br /> / G Sampling Company Log Coda 1— <br /> �� �( Analysts Request �a <br /> Phone No FAX No Global fD <br /> U <br /> 16 S3uc, OC�z 02 ?3 T 06 O 7'O O a2 O Q d <br /> Project Number PO No EDF Deliverable To(Email Address) W m a T <br /> m logW 'u5 u� w � Q <br /> Project Name Sampl Sin e $ ? N -cc 0 <br /> wui �' m �a <br /> Pro ect Address — a 4 ° <br /> /�7G ���K us Sampling Container Preservative Matrix o k - y ry <br /> d m m y w co Q <br /> i b �} N x m e m W m > 0 <br /> �>j TclzT: C—W) <br /> IL i�iF `Oya m ai IL z r -Sam le Desi nation Date Time a u, z z r°n m '� ° ° ° <br /> F i— F- of ti irs h J <br /> / 3 <br /> 4116 <br /> 5 <br /> I Relinquished by D 1e Time Received by Remarks <br /> y/fo d �i <br /> LRefinqumhed b to Time Received by <br /> Relinquished by —Date-- <br /> Ti me Recelved by Laboratory Bill to <br /> Disenbubon While Lab Pink Ongrrtafor <br /> Formslcoc 121001 019 <br />
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