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ARCHIVED REPORTS XR0007818
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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E
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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 XR0007818
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Entry Properties
Last modified
7/15/2019 5:57:55 PM
Creation date
7/15/2019 4:33:43 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007818
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 CHAIN OF CUSTOD RECORD <br /> Of <br /> GeoEnvironmental, Inc ( rJ � Date Xl Pase <br /> 837 Shaw Road Stockton, California 95215 - (209) 467-1006 Fax (209) 467-1118 <br /> Client t <br /> Project Man Test&A aired <br /> P one Nu ber <br /> Sa r/d (signature) Invoice <br /> f � t AGE ❑ <br /> Project Name t ( ` Client <br /> Sample Type <br /> Sample LocationNo of / Notes <br /> Date Time Water Solid � <br /> Number Description comp J crab Air Conts <br /> loo <br /> + ' wog <br /> 4L-1� <br /> 4- e) _W <br /> Ir <br /> Metine y Srgnat ref E ecetve y ignature i D to rm <br /> Relinquished by (Signature) Received by (Signature) Dale rme <br /> Relinquished by (Signature) deceived by Mobile Laboratory for field analysis (Signature) DatefTime <br /> } <br /> Dispatched by (Signature) Datel7rme iia aboratofy by �taJTime _ <br /> -� r35 /5a <br /> let <br /> Method of Shipment Laborat fy Na ; <br /> h t � _ utif;� y) <br /> Special Instructions ITICLlt• �� I hereby autt6rj�s the erforma ce of the above indicated work <br /> 1 !f GOOD CONDITION �s—APPROPRTA M �' / r) <br /> flLAD SCEPAABS( / <br /> CHORIVOA3NATLD IN LAB PRESLRVCD IN <br /> o LAB <br /> 0&47 METALS OTHER <br /> r <br />
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