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FIELD DOCUMENTS
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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EL DORADO
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2900 - Site Mitigation Program
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PR0505525
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Last modified
7/11/2019 10:27:23 PM
Creation date
7/11/2019 4:48:20 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0505525
PE
2953
FACILITY_ID
FA0002387
FACILITY_NAME
KEYSTONE AUTOMOTIVE INDUSTRIES INC
STREET_NUMBER
632
Direction
S
STREET_NAME
EL DORADO
STREET_TYPE
ST
City
STOCKTON
Zip
95203
APN
14907033
CURRENT_STATUS
02
SITE_LOCATION
632 S EL DORADO ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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Advanced CHA N OF CUSTODY RECORD <br /> �. rL � <br /> GeciEnvironmental, Inc. Date Jq Page <br /> 4005 North Wilson Way-Stockton California X52}5- <br /> (209)467-1006-Fax(2()9)467-1111 <br /> Client Project Manager <br /> S fro � Tests Required <br /> &L, <br /> Phone Number <br /> Samplers: (Signature) Invoice: <br /> Project Name �� 1 AGE <br />� (�(J Client <br /> Sample Location Sample Type No. of <br /> Number Description Date Time Water Solid Notes <br /> p comp. crab. Air Conts. , <br /> I ✓ 88428 ; <br /> N88429 <br /> j16- <br /> , <br /> C' <br /> e inquis a y: ignat re ve y: Si re Date[Tl C <br /> {5 s T` gU <br /> Rets qws ed by. (Signature) B&6ived by: (Mg nature) � � Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by:(Signature) Date/Time Received for Laboratory by: Date/Time <br /> Method of ShipmwM <br /> Q Laboratory Name <br /> T M G ca—q�(A e.& <br /> Special Instructions: �0 O&G] METALS hereby OTHER I authorize the performance of the above Indicated work. <br /> 4 <br /> GOOD CONDITION- -- APPROPRIATE - <br />
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