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ARCHIVED REPORTS XR0010905
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 XR0010905
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Entry Properties
Last modified
8/1/2019 3:36:50 PM
Creation date
8/1/2019 2:42:46 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010905
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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SJGOV\wng
Tags
EHD - Public
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_ t— LJ 7 <br /> `,Advanced <br /> CHAIN OF CUSTODY, CORD <br /> Date 102�-Tq Page of I <br /> GeoEnvironmental, Inc. <br /> 4005 North Wilson Way-Stockton, California-95205-(209)467-1006-Fax(209)467-1118 <br /> t-:;L1401 7_PrG& 15S &C)C <br /> Client Project Manager <br /> u L Tests Required <br /> Phone-Number <br /> A-2 -16)o(, <br /> Samplers: (Signature) <br /> Invoice: <br /> Project Name AGE E] <br /> f k f VA ,ate Client 0 <br /> T <br /> Sample Location Sample ype <br /> Number Description Date Time Water Solid No. of Notes <br /> Cor Air Conts. <br /> 24159 <br /> MW I C) -;Is 16,2FJ9 11415' )< <br /> I T057 ' 2460 <br /> 24161- <br /> X <br /> x 24162 <br /> tv <br /> 24163 <br /> 24164 <br /> Aelinqu�shed by: ignaiure) Rece�yed by: (Signature) <br /> e, /0- -2 Date/Tirne <br /> � <br /> Relinquished by: (,�ignature) ta <br /> d by: (SignatL& DatefTime <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) DatelTime <br /> Dispatched by: (Signature) DateFrirrfe Received for Laboratory by: <br /> DaterTime <br /> Method of Shipment: nn Laboratory Name <br /> �2221 er. <br /> Special Instructions: VQ&GMETALSOTHR I hereby authorize the performance of the above indloated work.J$J J 1 E <br /> W <br /> GOOD CONDITION (1PP_R'0'P"R'I'A'T'WE" <br /> HEAD SPACE AD -_ �m A <br /> DON11 X UUNIAINLH� <br />
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