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ARCHIVED REPORTS XR0010900
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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E
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ELKHORN
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1050
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2900 - Site Mitigation Program
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PR0505234
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ARCHIVED REPORTS XR0010900
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Entry Properties
Last modified
8/1/2019 3:17:02 PM
Creation date
8/1/2019 2:42:29 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010900
RECORD_ID
PR0505234
PE
2951
FACILITY_ID
FA0001103
FACILITY_NAME
Elkhorn Golf Club
STREET_NUMBER
1050
STREET_NAME
ELKHORN
STREET_TYPE
DR
City
STOCKTON
Zip
95209
CURRENT_STATUS
02
SITE_LOCATION
1050 ELKHORN DR
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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--------- --- ...... <br /> 7 <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. a6 Li -3Ci'-ZGk-C'o &CC--, Dall+- 7� Page of <br /> 4005 North Wilson Way-Stockton,California-95205-(209)46T-1006-Fax(209)467-1118 <br /> clientrf Project Manager Tests Required <br /> Phone Number <br /> Samplers: (Signature) Invoice: <br /> Project Name AGE <br /> Clientz <br /> Sample Location Sample Type No. of <br /> Number Description Date Time Water Solid Notes <br /> Comp. Grab. Air Conts.. <br /> 391-01 <br /> ct z <br /> I 1x1 I <br /> 20� t 39102 <br /> IGEIPS LOOO <br /> dG 'Oq0TY <br /> AD 'ER <br /> h* <br /> Refinq he y: (Signature Ti—a—ce-i`v`edTy— (gignature) f Date/Time <br /> Relinquished by; (Signature) Received by: (Signature) Npf Ter DaterTIme' <br /> Relinquished by; (Signature) Received by Mobile Laboratory for field analysis: (Signature) DaterTime <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: Datemme <br /> Method of Shipment- <br /> 0 <br /> daboratory arae <br /> e <br /> Special Instructions: I hereby suth ize the performance of the above indicated work. <br />
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