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ARCHIVED REPORTS XR0006114
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 XR0006114
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Entry Properties
Last modified
6/21/2019 12:58:18 PM
Creation date
6/21/2019 10:43:58 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006114
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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TANALYTICALDavi 2nd Street, Sude 3a0Da�ls,CA 95616 <br /> ccc Lab 530 297 4800 <br /> Fax 530 297 4808 Lab No _ � <br /> Protect Contact{Hardcopy or PDF To) Page vt <br /> California EDF Report?3Ue5 ON, <br /> 7:22r'e Chain-of-Custody Record and Analysis Request <br /> Company/Address <br /> Sampling Company Log Code ! <br /> none No ' ` ���t�-tom 6' �' Analysis Request a <br /> FAX No Global ID 6 5z <br /> t" <br /> Project Number P p Noo QI u <br /> EDF deltverabie To(Erntsll Addresu) m <br /> Protect Name Sampler Stg a ure �, a <br /> ww p t rA <br /> Protect Address m <br /> z x v <br /> Sampling Container regervative Matrix o <br /> U.1 tn w w .. <br /> Sam le Designation ° w z a <br /> Date Time v vJs i i z a p a ce j=� o o O <br /> U7 m m F F- 1- N f~ N n J W i N <br /> y <br /> W Zz6 ' I <br /> k1 <br /> TTI L-1-1i <br /> Relinquished by D e Time Received by <br /> Remarks <br /> Relinquished Time Received by <br /> Relinquished by Date Time Received by Laboratoryi <br /> Bill to <br /> Drslnbtd= MdO-Lab Pink-Odgmalar <br /> Formshbc 121401 Rn9 <br />
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