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ARCHIVED REPORTS_XR0003804
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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HAZELTON
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2900 - Site Mitigation Program
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PR0540905
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ARCHIVED REPORTS_XR0003804
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Entry Properties
Last modified
2/3/2020 9:52:59 PM
Creation date
2/3/2020 9:18:23 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003804
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 Advanced <br /> CHAIN 9Page <br /> STODY*, CORD , <br /> GeoEnvironmental, Inc <br /> Date of� <br /> 837 Shaw Road- Stockton, Calliornia- 95215- (209)467 1006- Fax (209) 467-1118 <br /> Client Project Manager <br /> Tests Required <br /> P <br /> one ,,m?r <br /> �01�1 ,1 7- /60.9 <br /> Samplers (Signature) Invoice <br /> Protect Name AGE� � Client ❑ <br /> Sample Type <br /> Sample Location rt o o <br /> N /( '�C' <br /> Date Time Water Solid �' Notes <br /> Number Description Comp Grab Air Conts <br /> ►�r � 2uc I�'�-��r 2� '3 U �j <br /> �'t►i -2 rz t X AA Xb <br /> IAwl_ ,4 r���_L1 �X X <br /> vu,�•- ti1� -�, 122 M <br /> e inquis e y cure) eceive y (Signature) Qat ITrme <br /> 2z{ b5 00 <br /> Relinquished by (Si nature) Received by (Signature) Date/Tim <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> 4 <br /> Dispatched by (Signature) Date[Time Received for Laboratory by _ 7 Date/Time <br /> Method of Shipment Laborar Name <br /> � r clCL C <br /> Special Instructions �t I hereby authorize the erformance of the above Indic ed work <br />
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