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ARCHIVED REPORTS XR0006118
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 XR0006118
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Entry Properties
Last modified
6/21/2019 1:33:18 PM
Creation date
6/21/2019 10:46:59 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006118
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 /> /FF Davis,CA 95616 <br /> Lab 530 297 4800 <br /> ANALYTICAL LLC Fax 530 297 4f308 tab No 4 Page Z of <br /> Protect Contact(Hardcopy or PDF o) California EDF Report'>'$4-yes ❑No Chain-of-Custody Record and Analysis Request <br /> Y Y q <br /> Co pany/Addrsss���r� Rrcarmwraedeuerw� w urssec�on F <br /> Sampling Company tog Code Analysis Request F <br /> honeNoy�� FAX No Global ID <br /> /� p tpp m X <br /> V e-rW/y33n ���C) /3 V 6 D O Z- CO N (V N w <br /> Project Number PO No EDF Deliverable To(Email Address) xx mm m o a, <br /> CD <br /> m o W ul w Nu C <br /> N _ N <br /> Project Name Sampler Sign re "' w m � ca �a a o H <br /> CO w <br /> Project Address 2 n N ° N 16 <br /> i Sampling Contains Preservative Matrix a �, N -.1 <br /> �L G 0 w N = o m m 1p C 0 l0 CV t U. <br /> co- �, w w W c� �, Fr, T vii m m v N <br /> E w� z w p a p " "� z z z o 0 0 0 a ° L <br /> Sample Designation Date Time a rn z = z 3 to CO ti v, w <br /> ��✓ � qtr v y( �( �^e�. <br /> 144 A-."/0 <br /> i <br /> i <br /> Relinquished by, Date Time Received by Remarks <br /> Rehnqurshed b 'Die Time Received by <br /> Relinquished by Dale Time Re ived by Laboratory Bill to <br /> ��- <br /> Drsfnbuhon White-Lab Pink-Ongrnator Formslroc 121001 fh9 <br />
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