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ARCHIVED REPORTS_XR0007228
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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E
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88 (STATE ROUTE 88)
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13975
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2900 - Site Mitigation Program
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PR0522057
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ARCHIVED REPORTS_XR0007228
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Entry Properties
Last modified
11/20/2024 9:21:19 AM
Creation date
9/5/2019 2:18:14 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007228
RECORD_ID
PR0522057
PE
2950
FACILITY_ID
FA0015024
FACILITY_NAME
USA GASOLINE #3756
STREET_NUMBER
13975
Direction
E
STREET_NAME
STATE ROUTE 88
City
LOCKEFORD
Zip
95237
APN
01908014
CURRENT_STATUS
01
SITE_LOCATION
13975 E HWY 88
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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Tags
EHD - Public
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� Advanced CHAIN OF CUSTODY RECORD <br /> r <br /> GeoEnvironmental, Inc. Date �911� ?S Page of—k <br /> (!f Northeast Caltfonira <br /> 1803 West March Lane,Suile A Stockton, California-95207-(209)95640264-Fax(209)956-0700 ,21 <br /> Client Project Manager � Tests Required <br /> Phone Number <br /> 0 _���-`� <br /> Samplers (Signature) Invoice <br /> AGE KPro)ect Name Wi Client ❑ <br /> Sample Type <br /> Sample Location Date Time Water Solid No of 1 Notes <br /> Number Description Air Cont <br /> Comp crab s <br /> �bvph-1 ���� IQ, z k s� <br /> 4-b- Z le.�Z ✓ <br /> a ,;534�e <br /> 4-a- 7 ✓ f o,�Z. �u' 1 <br /> Dare/Time <br /> Relinquished y (SignaGue) e y 'tgn a (o4�4-S;.� _ )ten -•,� T� '�� G � �S � �� <br /> Relinquished by (Signature) ved by (Signature Date/Time <br /> r t w � Ufa �`�i'J.",o,villi it <br /> Relinquished by (Signat�trc �• borabry fog} held analysts (Signature) Datelttme <br /> 060C CONLIMM <br /> Dispatched by (Signaturj_R1 SPACE�pcfp Time Received for Laboratory by DaleJTlme <br /> ii 111u1 f VGfiD.7fllt —COMMM <br /> _ Laboratory Name <br /> ethoda;&R64i <br /> h <br /> — <br /> Special Instructions I hereby authorize the performance of the above indicated work <br /> I <br /> � S "�2- <br />
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