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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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s • 3 • <br /> i <br /> 1 <br /> 2795 2nd Street, Suite 304 <br /> Davis,CA 95616 <br /> Lab 530 297 4800 <br /> ANALYTICi4L I-LC Fax 630 297 4808 Lab No Paged"Z of <br /> Project Contact(Hardcopy or PDF To) California EDF Report? ❑ Yes Chain-of-Custody Record and Analysis i equest <br /> Company/A ess,/,e- :6� ► w2MVYgROftwC&M <br /> Sampling Company Log Code Analysis Request <br /> Phone No FAX N6 Global ID o x f <br /> �3a&F S3 f�o GGA oz 73 z C3 8 w h <br /> Project Number PO No EDF Deliverab o(Em VAddress) o <br /> N 1J O <br /> Pro Pct Name / Sampler Signa m o � w r <br /> pn <br /> Project Address / Q Sampling ContanePreservativMatrix _ <br /> f76Cov��A s ►- '�Y av v i <br /> a <br /> R <br /> UJI a o��o a 2 <br /> m W kir <br /> E J U z V 0 Q O � � � z S O O O <br /> Sample Designation Date Time ' u4 x _ z rn <br /> I <br /> k <br /> i <br /> i <br /> I <br /> I <br /> L I <br /> t <br /> i <br /> Relinquished by /Date Time j Received by Remarks <br /> _ ! i i !4✓v <br /> Rehnqu hed by Dae Time Received by <br /> i <br /> Relinquished by !ale 7� Received by Laboratory � � / gill to <br /> 1 <br /> ---- --- - - k . <br /> Dislnbuhon White-Lab, Pink-Onginator Folmsfcoc 121001 fh9 <br />
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