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ARCHIVED REPORTS_XR0003760
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_XR0003760
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Entry Properties
Last modified
2/3/2020 9:59:21 AM
Creation date
2/3/2020 9:05:34 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003760
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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i >! � � � I� � � � � i• tti � � � � � <br /> l� Advanced CHAIN OF CUSTODOECORD <br /> ed <br /> GeoEnviron men tal, Inc dace Irf Page —J— of <br /> 4005 North Wilson Way Stockton,California 95205-(209)467 1006 Fax(209)467 1118 <br /> Client ` P ro ect ana er l�S Z-� <br /> �� <br /> Lvfn8� �� Tests Required <br /> o t <br /> Phone Number <br /> S ' <br /> lers (Signature) 1' (n Invoice <br /> Project Name C '� AGSr - L l tir-� �, Client ❑` <br /> Sample Location Sample Type i <br /> Date Time ` <br /> Number Description Water Solid <br /> ° °f /� <br /> Air ContS <br /> Comp Grab <br /> x^ r" <br /> rti�VV`� "10 I SFU SC ] 326 <br /> }3 <br /> f i"ry r "t)" <br /> qz- <br /> 11 <br /> 111 <br /> XX <br /> � f , 9-717, <br /> ��ll t` `C [/rL l it `J7tri,332 <br /> - :13330` iM <br /> r <br /> V�`r' z,13 3 31 <br /> Re��nqmed <br /> nques a by egna -e) <br /> e e v y ig r <br /> /4Ar (a_la- Date/Time <br /> I �. <br /> {Segnalure) rued by {Signal re ��� �� 51� 1� kito <br /> fCEI�� VOA &G ME��� � R <br /> Relinquished by (Segnalure) Received by Mobile Laboratory for held analysis (Signature) GQUQ Pn}��ITI�� J PRESERVATION <br /> UU CONDITION I IENL:„ gpPROPRIATE <br /> Despatched by (Signature) Date/Time Received for Laboratory T71G�S� DateJTeme <br /> Method of Shipment i Laboratory Name <br /> AA CCo <br /> Special Instructions 1 hereby authorize the performance of the above indicated work <br /> -Ms,caqRV/ <br /> 1 '11,4c SIIIA'. <br />
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