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ARCHIVED REPORTS_XR0002519
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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G
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GRANT
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308
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2900 - Site Mitigation Program
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PR0542014
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ARCHIVED REPORTS_XR0002519
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Entry Properties
Last modified
1/16/2020 6:07:18 PM
Creation date
1/16/2020 4:20:28 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002519
RECORD_ID
PR0542014
PE
2960
FACILITY_ID
FA0023306
FACILITY_NAME
LARRYS AUTO REPAIR
STREET_NUMBER
308
Direction
N
STREET_NAME
GRANT
STREET_TYPE
ST
City
STOCKTON
Zip
95205
CURRENT_STATUS
01
SITE_LOCATION
308 N GRANT ST
P_LOCATION
01
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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' i0 <br /> Advanced CHAIN OF CUSTODY RECORD <br /> ^-7 Date -7v` Page -L—ot2, <br /> GeciEnvironmental, Inc. <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 I OH <br /> i r7G, _1 0G <br /> Client L e(V'r r d Protect Manager��-'vf I_t ! ^c Tests Required <br /> Phone Number j <br /> �6 <br /> Samplers (Signature) Invoice. <br /> (GccG 7 AGE <br /> Project Name f�p p f f A to l 0 Client ❑ <br /> y <br /> Sample Location Date Time Solid <br /> Type No of <br /> Water J ' i <br /> Number Description Comp Grab Air Conts <br /> M 2�, <br /> i L <br /> e wa had ( ignatur eceived by ignature) UatejnuT <br /> l �t� 5 ya rt�a trd r•�.T- '�� <br /> Rel h (I by(Signature) Roca ved by (Signature) Date Mme <br /> Relinquished by (Signature) ceived by Mobs Laboratory for f� id analysis (Signature) Date/Time <br /> I <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Date[Time <br /> Method of Shipment Laboratory Name MC <br /> Special Instructions I hereby authorize the performs ce of the above indrealed work <br /> VOAS O&G METALS OTHER .�. - �fnitoriff &A M10MV HUN � <br /> GOOD CONDITION J APPROPRIATE <br /> HEAD SPACE ABSENT CONTAINERS <br />
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