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EnvironmentalHealth
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EHD Program Facility Records by Street Name
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ELLIOTT
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21001
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3500 - Local Oversight Program
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PR0544725
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Last modified
8/1/2019 3:44:29 PM
Creation date
8/1/2019 3:11:33 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0544725
PE
3528
FACILITY_ID
FA0010533
FACILITY_NAME
LOCKEFORD PLANT MATERIAL CNTR
STREET_NUMBER
21001
Direction
N
STREET_NAME
ELLIOTT
STREET_TYPE
RD
City
LOCKEFORD
Zip
95237
APN
05121038
CURRENT_STATUS
02
SITE_LOCATION
21001 N ELLIOTT RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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CHAIN OF CUSTODY RECORD <br /> =� Geological Audit Services , Inc . Date /,,.�2Pa k <br /> — -• F17Vftnmenta/Pro%ssronals -!?��r Page OL9 <br /> •' <br /> 1001 West March Lane, Suite A•Stockton, California•95207•(209)456 026 <br /> Client V✓i�R _ c„� : Pro•ect Manager Tests Required <br /> Phone Number <br /> 20 <br /> Sam le : (Signature) Invoice: <br /> Project Name ✓D� - 5 c S `C��% r ~�`G�- J/ / i GeoAudit <br /> !v r� <br /> i N v Client <br /> Type <br /> ype <br /> Sample Location SampleNo. of � , <br /> Number Description Date Time Solid <br /> Water / `/ / Notes <br /> _ Comp Grsb Alr Corns. <br /> xi <br /> � ` ___ •-318 12 <br /> $2 � Z = t <br /> Fz -tio �� i E _31813 <br /> 1 r <br /> k'-1,nJ.-s4.d <br /> � •.ass��.._.stun) ecaw y: Ig tun Dy: (Signature) Received by: (Signature) PjrM.0cE> Date/Time <br /> rel nqulsned by: (Signature) Received D Mobile Laboratory for field analysis (Signature)y rY Y f 9 ) Oaiei7ime <br /> Dispatched by: (Signature) Date/Time Received for laboratory by. Date/Time <br /> Method of Shipment: (ST►Jtp Laboratory !Jam* <br /> Specialtnstruc/ige,�tn CONDITION APPROPRIATE 1 hereb horiz. th. ►mane. ort a above indicated work. <br /> 'IrrlAr% nit-171 V <br />
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