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SITE HISTORY
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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3500 - Local Oversight Program
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PR0545289
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SITE HISTORY
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Last modified
2/11/2020 9:41:21 AM
Creation date
2/11/2020 8:33:18 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE HISTORY
RECORD_ID
PR0545289
PE
3528
FACILITY_ID
FA0003828
FACILITY_NAME
VAN BUSKIRK GOLF COURSE
STREET_NUMBER
1740
STREET_NAME
HOUSTON
STREET_TYPE
AVE
City
STOCKTON
Zip
95206
APN
16307036
CURRENT_STATUS
02
SITE_LOCATION
1740 HOUSTON AVE
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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M/J � p _� CHA2N OF CUSTOCY RECC]RJ' �y <br /> General Engineering Contractors Client' s Name <br /> Post Office Box 5660 Lab ::—( <br /> #s: Invoice No- <br /> Fresno, <br /> o_Fresno, California 93755 <br /> project 1l0. Project Narne/Lacatian Determination Requested N C Condition of Sample <br /> u fl <br /> in n r r <br /> � LJ1 b t ' C e <br /> Samplers; <br /> (Signature) 4 r i e e <br /> i <br /> n a 1 r <br /> o e 1' 1 Y <br /> Sampled f r e e e <br /> P e;�a !ts <br /> Description Date ' Time s <br /> d d d R r• <br /> S .S, t,G, 111 Lc <br /> Ific) l43s— <br /> SS, 3t <br /> VRelinquished By : DaCelTira Reesived Sy : <br /> Yi qu shed By : Date/Time Received By <br /> ivad By <br /> Aelinq ishe--d By : Date/Ti s Re i wd By : �¢ Ralinquiahad By: outs/Time Reca : <br /> 1131W 10 <br /> Data Tiwe <br /> Relinquished By : Date/Ties Rec• lve Ey : Recelvad For Lab By : <br /> / <br />
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