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ARCHIVED REPORTS_XR0002521
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0542014
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ARCHIVED REPORTS_XR0002521
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Entry Properties
Last modified
1/16/2020 6:16:56 PM
Creation date
1/16/2020 4:22:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002521
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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Advanced CHAIN OF CUSTODY / CORD <br /> GeoEnvironmental, Inc. hate 7 Page r of <br /> of Nonhc171 Calffonna I <br /> 1803 West March Lane,Suite A-Stockton California 95207 (209)956-0264 Fax(209)956-0700 9fa 3 X A oZ93 CYC <br /> l Project Manager / 'f Tests R cared <br /> Client4'�t- f ]� F �/� r� ��_/-�.J /V" fay <br /> Phone Number <br /> Samplers (Signature) �1 Invoice <br /> U AGE <br /> Project Name ' /�,') ; Q/ <br /> `a� Client ❑ <br /> Sample Type � <br /> Sample Location Date Time Water — Solid No of � � o � t <br /> Number Description Comp crab Air Conts <br /> r <br /> ILO <br /> MA' 0 <br /> 0 7 <br /> V f• <br /> —2V47 i r��� <br /> jjy <br /> 7 +�7 t vC, <br /> e in is e y (Signa u e) Received by (Sig natuie Iq ' <br /> W �, �OG r� Citi 7–&-- /w`]�lC. /� ' r 67—Z _/ 7 S b-7Z t <br /> L <br /> Relinquished by (Signature) Received by (Si ature) Date/Time <br /> 41, <br /> Relinquished by (Signature) Received y Mobile Laboratory for held analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Date/Time <br /> Methodof Shrpmc Laborai ly Name r <br /> i ( J (`� C <br /> Special Instructions Y - 1 1 I hereby euthorrze 1he performance of the above indicated work <br /> i'iJ <br /> } , r a rl� i}�" ��t•�si47e a� <br />
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