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ARCHIVED REPORTS XR0007853
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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EL DORADO
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706
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3500 - Local Oversight Program
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PR0544664
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ARCHIVED REPORTS XR0007853
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Entry Properties
Last modified
7/17/2019 1:03:57 PM
Creation date
7/17/2019 10:08:17 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007853
RECORD_ID
PR0544664
PE
3528
FACILITY_ID
FA0004958
FACILITY_NAME
CHARLIES DAY & NIGHT
STREET_NUMBER
706
Direction
N
STREET_NAME
EL DORADO
STREET_TYPE
ST
City
STOCKTON
Zip
95202
APN
13905410
CURRENT_STATUS
02
SITE_LOCATION
706 N EL DORADO ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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l• I• 1• <br /> ( Advanced CHAIN OF CUSTODY RECORD <br /> " GeoEnviranmental, Inc �F3! sate 0 1 Page _. or__...� <br /> 837 Shaw Road Stockton California-95215 (209)487-1008- Fax (209)487-111a 47 <br /> i <br /> Client Project a <br /> ATests Required <br /> n <br /> Phone Number � <br /> A-v !1 <br /> Samplers Signature) O Invoice <br /> Project Name /-A)'Vb— <br /> Client ❑ 5 <br /> Sample Location ample Type <br /> Date Time Water �{ Solid No <br /> Nof <br /> lrmber Description L Notes <br /> comp arab <br /> Vii' N <br /> ts <br /> 'r w W <br /> _lip- <br /> �' Lo ili 7-0c) <br /> fol Y - n 0 <br /> ' /y(� J( y� <br /> V V �i � /� `�a" <br /> 401 01 4 ] IxL- I IT <br /> e g i e y gnalure ace ve y gna ursf)ate/Tlma T <br /> Rat d 6 ( ria ure) Received by (SIgnaturo) 0 5 01 1 00 <br /> 11teRrmo _ <br /> b (Signature)Ralin u shed <br /> 4 Y nature 9 ) Received by CVIoldlls laboratory far field analysis (S+pnature) Oats/Time <br /> Dispatched by (Signature) Date/Time scot or abortory b <br /> V AS O&G METAIS OTI{E {� t)ato(Tlme <br /> Method of Shipment laboratory Nome ��r ��t <br /> KS4RVATIOI� _ <br /> v <br /> CD <br /> Special Instructions t't ! here uthorl the <br /> r! <br /> I SPACE A85ECJT CONTAI ERSperformance of the above Indleated work G) <br /> 4 ts1 <br />
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