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ARCHIVED REPORTS_XR0003806
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_XR0003806
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Entry Properties
Last modified
2/3/2020 10:07:49 AM
Creation date
2/3/2020 9:19:42 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003806
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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���r�� tllttill� � � �� � �j�■�� � � � � � � � <br /> [ Advanced CHAIN OF CUSTODY RECORD] <br /> GeoEnvironmental, Inc. Date Qs-► 3-o�I Page j <br /> of <br /> 837 Shaw Road Stockton, California- 95215 -(209)467 1006 Fax (209)467-1118 <br /> i <br /> Client 5 Project Manager <br /> Tests Required <br /> Phone Number <br /> Samplers (Signature) G1 invoice <br /> Project Name e �� L- �t, AGE <br /> Cllen <br /> Sample Location Sample Type <br /> Number o of <br /> Description Date Time Water Air Solid Conts �� j Notes <br /> comp Grab <br /> 'I- r A,)E A 1 Al q, ISP 155 <br /> � �"� '� �5 � �✓"13 4 �� e �'�Cj 5 I PQ�e <br /> AT <br /> w �X3 <br /> Rerinquished by Signature Received by'(Signature) <br /> Date/Time <br /> Relinquished by (Signature) Received by (Signature) GOOD �tTt�K^-�---,-.. APPROPRYAW DatelFl e <br /> HEAD SPACEABSENT. CQN7'AINE <br /> DEQ1LORINailWIN PRESERVED IN <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Vom <br /> Pado TAI3 OI7� Oata/Tune <br /> PLEMWATTON <br /> Dispatched by (Signature) Date/Time pec pleaboratory by <br /> 'Wlovto/Ti//W6- <br /> Method of Shipment Laboratory Name <br /> CA <br /> Spector Insttuc8ona I hereby authorize the performance of the above indicated work <br /> REC'Q SEALED&INTACT YEA '�' U --' /7! L� `•`� <br />
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