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ARCHIVED REPORTS_XR0003261
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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H
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HOUSTON
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1740
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3500 - Local Oversight Program
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PR0545289
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ARCHIVED REPORTS_XR0003261
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Entry Properties
Last modified
2/11/2020 9:55:24 PM
Creation date
2/11/2020 8:46:34 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003261
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
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date Page of <br /> 837 Shaw Road-Stockton, California-95215 - (209)467-1006 - Fax (209)467-1118 <br /> Client Project Manager <br /> Tests Required <br /> .one Number <br /> -a ers: (S' nature) f' . Invoice: <br /> Project Name <br /> L <br /> AGI=.� <br /> Client 11�' l V) ❑ <br /> 11 <br /> Sample Type ' <br /> Sample Location pate Time Water Solid No. of Notes <br /> Number Description Date <br /> drab• Air Conts. <br /> 2 <br /> X.M Lu ZZ <br /> �k1�/�t,to) �z C� � - <br /> e inq s bd tgnat re Received by: (Signature) Date/Time <br /> Tr <br /> ti '•nr __... ._... .. .. <br /> ffEY3i�&J � 1* Cf,41s <br /> Relinquished by: signature) I Received by: (Signature) A a CONTAIN 7 —--• Date/Time <br /> VEGHWW"M IN LAN FE&VULLNTID LN <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) DatelTime <br /> Dispatched by;.(Signature) Date/Time rolljad ,or Laboratgry/hi( c -�f Oateftime <br /> Method of Shipment: Lai! rato yNa <br /> \Spe al Instructions: I hereby authotizilthe performance of the above Indicated work. <br /> „r 1 JV V <br /> v __ "� <br />
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