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ARCHIVED REPORTS XR0009819
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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E
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ELEVENTH
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515
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3500 - Local Oversight Program
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PR0544792
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ARCHIVED REPORTS XR0009819
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Entry Properties
Last modified
11/19/2024 10:19:00 AM
Creation date
9/3/2019 12:00:41 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0009819
RECORD_ID
PR0544792
PE
3528
FACILITY_ID
FA0004849
FACILITY_NAME
BILLS BAIT & BEACON GAS
STREET_NUMBER
515
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95376
CURRENT_STATUS
02
SITE_LOCATION
515 W ELEVENTH ST
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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SJGOV\wng
Tags
EHD - Public
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C d_ �I_, ��' CHAIN OF 7USTOD ECORD <br /> -� Geological Audit Services , Inc. CfX-� ,C� <br /> :.tt=r Erm1tanmenfa Pmfessnona& <br /> Date S~1$-q3- Page ot� <br /> 1803 West March Lane, Suite A Stockton California 95207-(209)956.0264 <br /> Now <br /> Client 1 , 4 r�- Project Manager Tests Required <br /> 5rS MA79-)� <br /> Phone Number � <br /> Samplers (Signature) / /Invoice <br /> Project Name S G W"'f��c.G ✓ i /� /Ge.Auda �Z <br /> / Client ❑ <br /> Sample Location Date Time Sateple Type Solid No of �� Notes <br /> Number Description Comp Ar Conts / / <br /> 1P - I co I. Al93-0&26 -la- 1 <br /> TP V w Cal,vlr Al <br /> TP- 3 Nt;10 5, k ►�qrt 3 <br /> -TP - 9 5 w '1$-q <br /> TP-5- <br /> 'TP — <br /> P-5-TP — bo`�7ddo year 5ou7n �Kc� I <br /> T - �a57 wa 1 I 7 <br /> Relinquished y ignatureReceived y n�� <br /> Da7/1 <br /> —Mm-e <br /> ';?44 L � a T6 4 - <br /> Relinquished by (Signature) Received b (Signature)Y ( g 1 DatafTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for Feld analysis (Signature) Datefrime <br /> Dispatched by (Signature) -T Daterrims Received for Laboratory by DatefTlme <br /> Method of Shipment Laboratory Name <br /> Special Instructions I hereby author !!!--7 <br /> he erformanee f the above indicated work <br />
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