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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
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EHD - Public
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GHX- N OF CUSTODY ROWRD <br /> �l.�.. aqtaMuTt rerv7"ce,,,,7*1nW. <br /> _ �ranmentaTPmlest�naLs 3 Date Q ` Q page of 3- <br /> 1803 <br /> 1803 Weat March Lane Suite A Stockton. CaMOM111 95207 (209)9W-0264Ew - + <br /> E E <br />'nt �; 5 e wQr �` Project Manager rests Required <br /> Bob Mav-)y <br /> Phone Number <br /> Samplers (Signature) ' ' ' / ,' Invoice <br /> t <br /> eject Name 15 k vv Q rl 5 5-e a C o ;i,ti .�,�� � //-! L\ t J / I GeoAudit <br /> Client ❑ <br /> Sample Location Sample Type No of <br /> Comp Gra <br /> Number description Date Time Water Air So4id Conts /'����� <br /> fi <br /> 22_�5 � <br /> . •14K3 An x �r <br /> r <br /> 1 i S <br /> ♦k.y 'y� li <br /> ir^���f�jS�''`'y <br /> Iurs e y ( rg;state► carve y ignatur ti Cate(f}m <br /> �►•�Mh� �� � � �i�-rT •fv 5�aitr�aYcti? 1• A_l.. 9'4•q� <br /> uished by (Srgnaturel Received by Ssrgneturef Datertme <br /> urahed by (Signature) Received by Mobde Laboratory for Heid analysis (Signature) oatefrime ! <br /> I <br /> :had by (Signature) Oatemme Fiecerved for Laboratory by aate�me <br /> I of Shipment Laboratory Name <br /> instructions _ _ I hereby authorize the performance of the above indicated work <br /> 99819M me <br /> IC PRE MATK� , �%� <br /> TSS» n Tt- i <br /> }` 400, �i <br />
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