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FIELD DOCUMENTS
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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LOWER SACRAMENTO
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18970
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2900 - Site Mitigation Program
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PR0516743
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Entry Properties
Last modified
3/4/2020 12:42:06 PM
Creation date
3/4/2020 11:30:31 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0516743
PE
2950
FACILITY_ID
FA0012768
FACILITY_NAME
WOODBRIDGE ARCO-STORE #5650
STREET_NUMBER
18970
STREET_NAME
LOWER SACRAMENTO
STREET_TYPE
RD
City
WOODBRIDGE
Zip
95258
CURRENT_STATUS
01
SITE_LOCATION
18970 LOWER SACRAMENTO RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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1 [ C f [ f [ [ C t t 1 f [ f t f 1 1 <br /> Advanced CHAIN OF CUSTODY RECORD <br /> Z���c�l <br /> --- GeoEnviron mental, Inc. Date Page 2 of <br /> ��2 <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 <br /> ClientProject Manager Tests Required <br /> Wao7 <br /> Phone Number <br /> Samplers: natur ) I nvoice: <br /> ProjectNameaz , e,� Client <br /> Sample Location Sample Type No, of ?t <br /> Number Description Date Time Water Solid 60886 <br /> P Air Conts. <br /> comp. crab. <br /> k-57 &j(,--- i -C 02-2& 13:06 <br /> 7 ee- - - R1 dc' <br /> -3 - jv � =� ( >� K 60887 <br /> 3-20 <br /> - -- ---- -- --- -- H 60888 <br /> ReFrnqu7 <br /> ad Receivedy: ignature <br /> f ti 60889 <br /> Relinq ished by: (Signature) Received by: (Signature) <br /> ;rfwPAcb 7 A •7"; 60890 <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(Signature) 1! 60891 <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: <br /> Method of Shipment: Laboratory Name <br /> Il'l C -A`z <br /> Special Instructions: I herebyuthorr thil btforma ce of the above Indicated work. <br />
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