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ARCHIVED REPORTS XR0012691
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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1129
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3500 - Local Oversight Program
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PR0544798
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ARCHIVED REPORTS XR0012691
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Entry Properties
Last modified
11/19/2024 10:19:10 AM
Creation date
9/3/2019 3:13:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012691
RECORD_ID
PR0544798
PE
3528
FACILITY_ID
FA0010953
FACILITY_NAME
BIG O TIRES
STREET_NUMBER
1129
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95376
APN
23229068
CURRENT_STATUS
02
SITE_LOCATION
1129 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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- - - <br /> 'i <br /> W- m- <br /> GeoAnalytical Laboratories, Ids.' 1'` ' I< 3°V k, <br /> 3031 Kansas Ave., Suite C t " ;.� i; <br /> Modesto, California 95351 " • Phono,(209) 572-0900 <br /> APR 110,1Fax #(209) 572-0916 <br /> £NV�RONN'IENTA,L,wE"Ohl <br /> CHAIN OF CUSTODY f ERM1T/sFRVICES f ~ <br /> Client ,.,o1J <br /> Address Phone <br /> CC to: <br /> Zi; <br /> ?ROJEt;T tD ANALYSIS <br /> - Na. s <br /> of <br /> SAMPLED - . (signs ure} con- <br /> lain. <br /> ars <br /> 58m e REMARKS <br /> - � <br /> Date Time Sample Location <br /> 1 crw raw. <br /> C Bo <br /> 99- 0 9 <br /> l; Rel' h b {sig tur <br /> Date Time R siv d by ignatu ): <br /> to Time <br /> Relinquished by re): <br /> Date Time Received by(signature: <br /> Date lime <br /> Relinquished by(signature): Date Time Received by(signature): <br /> Date Time <br /> Relinquished by(signs;ure): Date Time Received b4 (signature): <br /> Date Time <br /> Relinquished by(signature): Date Time Received by <br /> Date Time <br /> - ,- - - — -Site Time:-- ------- <br /> Start: <br /> --- - - -- - <br /> Drr:i^r T - - <br /> Stan: Finish: Total Hours: <br /> Start: Finish. Total Hours: <br /> e <br /> G�iati GIAMIC{(209)527-7657 - - <br />
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