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ARCHIVED REPORTS_XR0007233
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_XR0007233
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Entry Properties
Last modified
11/20/2024 9:21:19 AM
Creation date
9/5/2019 2:19:59 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007233
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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+� ■� til Ifl� � tiles s■■i tiiiii� � til � ..r }���"Nr�s�.. 'i tlitli� t� <br /> Peological Audit Services , Inc. CHAIN OF CUSTODY R RD <br /> C.7 Envr�rar�nerna Prn/fgssxx�aEs Date �� pays I of <br /> 100-3 VV421 March Lane, Suite A-Stockton Cdltornfa-95207-(209}956-0264 <br /> r <br /> Bw o re-' Project Mananer <br /> Ertl � L Tests Required <br /> Phbne Number <br /> Iv`f rj 5 L <br /> Sam lers (Signature) �,�(� Invoice• <br /> roject Name iG 1►� �, `( ( ��J �x 4l_ \ GeoAudrt <br /> client ❑ <br /> / <br /> Sample Location Sample Type <br /> Date Time Water Solid No of �� / <br /> Number Description Air Conts Notes <br /> Comp Grab 1 <br /> U��IUJ171 <br />!1 13 e y tgnature <br /> - statue y � patur. � OatelTime <br /> ehngmahed by (Signature) Received b r <br /> Y (Slgnatu e) <br /> Date/Tlme <br /> dinqutehed by (Signature) Received by Mobile Laboratory for field analysts (Signature) <br /> Dets/Time <br /> spatched by (Signature) 0ate/Time Recewed for laboratory by <br /> r]eteJTime <br /> thod of Shipment Laboratory Name <br /> tel Instructions <br /> WAS, �1 f tM i fl7��p 1 here�/by�uthori:e the performance o the abova Indicated work <br /> r t,I rl � � <br /> _ / <br /> Gaon G(�r�Gff��r� __ APPROPRIATE �' �� 'r.� <br />
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