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ARCHIVED REPORTS_XR0003765
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_XR0003765
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Entry Properties
Last modified
2/3/2020 10:15:41 AM
Creation date
2/3/2020 9:07:46 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003765
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 F CUSTODY RECORD <br /> __ ► <br /> GeoEnvironmental, Inc. crate /3o Page of�... <br /> 837 Shaw Road - Stockton, California- 95215- (209)467-1006-Fax (209)467-1118 <br /> Client Project Manager <br /> Tests Required <br /> P one Number <br /> g <br /> p rs• (Signature) Invoice <br /> Project Name AGS <br /> r <br /> Client ❑ <br /> Sample Location Sample Type No of <br /> Date Time Water Solid No <br /> Number Description Air Conts <br /> Comp Grab <br /> I ! <br /> a i 77938 <br /> I <br /> 77939' <br /> i <br /> VOA ALS 0TH R <br /> i <br /> GOOD ON191 Ti APPF OPF TE <br /> s. ri ►1 <br /> e i q is a ig ature ece va y (Signature) D taftime <br /> 0 <br /> v1� 1JAft <br /> Relinquished by (Signa r ) Received by (Signature) Date(rrme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analyses (Signature) e� DatelTime <br /> Dtapatched by (Signature) QatelTime Received for Laboratory by Date/Time"o C <br /> YSa <br /> Method of Shipment ora o fJa e <br /> ez <br /> 6�ik�E'A� <br /> Special lnsifuctions I hereby aut raze the rformance of the above indicated work <br />
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