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ARCHIVED REPORTS XR0007806
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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EL DORADO
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632
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3500 - Local Oversight Program
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PR0505525
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ARCHIVED REPORTS XR0007806
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Entry Properties
Last modified
7/15/2019 6:40:38 PM
Creation date
7/15/2019 4:26:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007806
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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MM MM IM ffffffff� f� <br /> Advanced ! CHAIN OF CUST# RE,-,i,. <br /> GeoEnvironmental, Inc. Date Page Z of <br /> 837 Shaw Road- Stockton, California-95215 - (249)467-1006- Fax (209) 467-1118 <br /> 12.Client Project Manager <br /> Tests Required <br /> Phone Number <br /> 6 <br /> Samp ers (Si nature) Invoice <br /> Project Name AGE <br /> Cjfent� <br /> Sample Location Sample Type / <br /> Number Description Date Time Water Air Solid No Of Conts <br /> Vtakz r2 Z <br /> Notes <br /> Comp Grab �j �/ i <br /> 1 d O X - /4 <br /> A 1:1 L4 —\L-- <br /> etinq hstews y ignature <br /> f) to 'in <br /> Relinquished by {Si Received by (Signature) ! <br /> ICEIt°� � atefT me <br /> Relinquished by (Signature) "PROPRIAT$ <br /> iiEZ 3pACEABSENT t tory for field anaiysis (Signature) DatefTime <br /> DECHLORINATED IN LAB RE5 VBU IN I A$ <br /> Q&G I W-TATAI MOR is], <br /> Dispatched by (Signature) PRESERVAFfON D 1efrime Received for Laboraio DatelTime <br /> L. <br /> Method of Shipment _ Lab 1 Name <br /> �"7 b <br /> Special lnstructi I hereby uthorize the performance the abov indicated work <br /> REED SEALED & INTACT VIA <br />
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