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ARCHIVED REPORTS_XR0003757
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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H
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HAZELTON
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375
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2900 - Site Mitigation Program
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PR0540905
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ARCHIVED REPORTS_XR0003757
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Entry Properties
Last modified
2/3/2020 10:04:07 PM
Creation date
2/3/2020 8:58:27 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003757
RECORD_ID
PR0540905
PE
2960
FACILITY_ID
FA0023406
FACILITY_NAME
SIERRA LUMBER MANUFACTURERS
STREET_NUMBER
375
Direction
W
STREET_NAME
HAZELTON
STREET_TYPE
AVE
City
STOCKTON
Zip
95205
APN
147120808
CURRENT_STATUS
01
SITE_LOCATION
375 W HAZELTON AVE
P_LOCATION
01
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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( Advanced CHAIN OF CUSTODY RECORD <br /> .- GeciEnvironmental, Inc. � ?j�j(p� Date Page Of <br /> 837 Shaw Road-Stockton, California- 95215-(209)467-1006- Fax(209)467-1118 <br /> I <br /> Client Pro ect M ler <br /> Tests Required <br /> P e Number <br /> Sa ers (S nature) Invoice <br /> Project Name AGE <br /> Client ❑ <br /> Sample Location Sample Type <br /> No of <br /> Number Description <br /> Date Time Water ASolid Coats Notes <br /> ? p Comp Grab Air it <br /> /V L �r ZL3 0 `e 30 <br /> WAS <br /> �— <br /> C01 rrMNERZ <br /> Relinquished y ignature ece ve y gnakure Date/Time <br /> Relinquished by (Signature) Received by (Signature) <br /> Date[Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatelTime <br /> Dtapatched by (Signature) DateJTime Rece a to Laborelory b ate/rime <br /> ago 9 Dd <br /> Method of Shipment Laborat ame ' <br /> SiLeclaijInottuctio I hereby uthorize erformance of the above indicated work <br /> ' r <br />
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