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SITE HISTORY
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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MENDOCINO
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1081
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3500 - Local Oversight Program
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PR0545548
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SITE HISTORY
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Entry Properties
Last modified
5/4/2020 9:58:01 AM
Creation date
3/16/2020 4:26:49 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE HISTORY
RECORD_ID
PR0545548
PE
3528
FACILITY_ID
FA0001143
FACILITY_NAME
UNIVERSITY OF THE PACIFIC
STREET_NUMBER
1081
Direction
W
STREET_NAME
MENDOCINO
STREET_TYPE
AVE
City
STOCKTON
Zip
95211
CURRENT_STATUS
02
SITE_LOCATION
1081 W MENDOCINO AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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CHAIN OF CUSTODY RECORD Bill TO SHERWOOD LABS <br />� P.O. BOX 937 <br /> Sherwood P.O. Box 937 N.Lander Avenue HILMAR,CA 95324 <br /> P.O. <br /> Hilmar, California 95324 V, 24i !g(S <br /> Labs (209)667-5258 Attemlon. Phone: 58 <br /> C O R P O R A T I O N FAX (209)667-2581 "921209-667-52Page of <br /> Job Number P.O.I Project Name <br /> T)eL <br /> Samplers:(Signature) Site Address <br /> P <br /> y SAMPLE LOCATIONNUMBER TYPE DATE TIME SAMPLE 88 R?R 11 12:26 <br /> (IDENTIFICATION) (UTH/DAY/YR) (HOUR/M" OF (GRAB OR MATRIX <br /> ` <br /> CONTAINERS COMPOSITE) <br /> n REMARKS ■` ` <br /> n 1DTu --T I N — 13 OrMo So I L <br /> 1130 V -�z <br /> TLL.s-PA-+ Tu= l l L0 + eorn ✓ -ani <br /> • f ! 5 ! nog b <br /> ✓ -cos <br /> J <br /> 1 <br /> 3 <br /> IJ <br /> d f <br />� a <br /> Y <br /> L <br /> is <br /> Rai d By:(Signature) DatdTirne _��.(� Received By:(Signature) De <br /> „ TURNAROUND TIME <br /> 1C IfIl, A? �� <br /> V M*gWg*d br.(S+grW-e) Date/raw Received By:(Signa Dat I e 24 HOUR ❑ <br /> a 48 HO <br /> d Relinquished By.(Signature) Date rime Received By:(Sig Dale/Time 5 DAY <br /> DISTRIBUTION: Original•Accompanies Shipment Canary Copy:Sherwood Pink Copy:Sampler NOTE:Samples are discarded 30 days atter results are reported unless other arrangements are made. <br />
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