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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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4032
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3500 - Local Oversight Program
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PR0544713
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Last modified
7/30/2019 3:48:59 PM
Creation date
7/30/2019 3:40:14 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0544713
PE
3528
FACILITY_ID
FA0007952
FACILITY_NAME
MARTINI AUTO
STREET_NUMBER
4032
Direction
N
STREET_NAME
EL DORADO
STREET_TYPE
ST
City
STOCKTON
Zip
95204
APN
11518501
CURRENT_STATUS
02
SITE_LOCATION
4032 N EL DORADO ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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7110ATSM KTAIS MER r. <br /> Advanced -- - ✓ P1rSCRVATIT11 CHAIN OF CUSTODY RECaRD <br /> GOOD COINDITICN , O APPS P'ri 1 Ali C y <br /> GeoEnvironmental Inc. NEADSPACAS�iVT Date a' - Page � of <br /> 4005 North Wilson Way•Stockton,California 95205 (209)457'1006�11`691M)467,1_1418. <br /> ClientProject Manager <br /> 51&_, 41 L-77-e- <br /> -Phone-Number .e? Tests Required <br /> Phone-Number <br /> Samplers: (Signature) v Invoice: <br /> Project Name � ' f &7�> <br /> vAGE E]( ClientAF <br /> ❑ <br /> Sample LocationSample Type , <br /> Date Time Water Solid <br /> Comp, No. of Notes <br /> Number Description Grab. Air Conts. <br /> Z -1_ - !� ✓ . _ 33 <br /> cs3 �1� 1� Z`5 <br /> q-5 <br /> 33436 <br /> t <br /> Relinquished y: i ature eceive y: ignature Dat /Time <br /> Relinquished by: (Signature) Received by: (Signature) Ate/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) <br /> Date/Time <br /> Dispatclied by: (Signature) DateTime Received for Laboratory by: Date/Time <br /> Method of Shipment: Laboratt Name <br /> Spacial lnstruttions: I hereby authorize the erfotmance of the above indicated work. <br />
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