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ARCHIVED REPORTS_XR0002196
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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G
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GRANT LINE
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2420
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3500 - Local Oversight Program
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PR0545209
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ARCHIVED REPORTS_XR0002196
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Entry Properties
Last modified
1/28/2020 9:00:45 AM
Creation date
1/28/2020 8:28:14 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002196
RECORD_ID
PR0545209
PE
3528
FACILITY_ID
FA0003963
FACILITY_NAME
TRACY76
STREET_NUMBER
2420
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
Tracy
Zip
95377
APN
23802006
CURRENT_STATUS
02
SITE_LOCATION
2420 W GRANT LINE RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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� � � I• � � � � �■ r•� �� � tittilttt� 1� t� <br /> Advanced CHAIN OF CUSTODYRECORD <br /> -=;,- GeoEnviron mental, Inc. Date +6 Page ! of / <br /> -" (yf Norlhem California <br /> 1803 West March lane,Suite A Slocklon, California 95207-(209)956-0264 Fax(209)_ 956-0700 <br /> Client Projectl Manager <br /> Tests Required <br /> Phone JJNumber <br /> Samplers (Signature) j Invoice <br />� Protect Name �ro� AGE�] <br /> Sample Location Sample Type No of `(" �' j /`� <br /> Number Description Date Time Water Solid \ / -_—Notes — <br /> Comp Carib Air Cionts F`f - := r <br /> k. <br /> r <br /> ��+Yj ��yy''��yy Q■1 4 <br /> 1 i <br /> �r <br /> a �I1 it <br /> i <br /> e n rs e y (Si r ece k(SipgnAtuJtL <br /> - / RatehT,rme��� � e7 ARRelinquished by (Signature) c d bDatellrme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Dale/Time <br /> Dispatched by (Signature) dale/Time Received for Laboratory by batelTrme <br /> i <br /> Method of Shipmen Laboratory Name <br /> `1 paaal(nSTTLC110nS i hereby authorize t e performance of the above indicated work <br /> t <br /> I;'-ID SPACF ARSFNT t/ Mt>MT11=q <br />
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