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ARCHIVED REPORTS_XR0012259
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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M
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MINER
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545
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3500 - Local Oversight Program
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PR0545551
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ARCHIVED REPORTS_XR0012259
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Entry Properties
Last modified
10/10/2020 11:26:33 PM
Creation date
3/17/2020 1:51:31 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012259
RECORD_ID
PR0545551
PE
3528
FACILITY_ID
FA0012578
FACILITY_NAME
CHETS AUTO
STREET_NUMBER
545
Direction
E
STREET_NAME
MINER
STREET_TYPE
AVE
City
STOCKTON
Zip
95220
CURRENT_STATUS
02
SITE_LOCATION
545 E MINER AVE
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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M @ <br /> � Advanced CHAIN OF CUSTODY RECORD <br /> Date /Q Page 1' <br /> GeoEnvtronmei<>Ital, inc.Y � �� ag or� <br /> 837 Shaw Hard - Stockton Cah1Grnia - 95215 (200) 467 1005- Fax (209)467-111803 <br /> CDa <br /> Client f Project Manager <br /> Tests Required <br /> D <br /> Phone Number <br /> Samplers (Signature) invorc fo <br /> Project Name / ff L , 1 AGE H <br /> Client ❑ <br /> Sample- Yp T e J <br /> Sample E Data Time Solid No of <br /> Number Description e WaterP l NotAS <br /> Camp Grab Air Coots <br /> r 81995 N <br /> a 0 1af�� K x ?c <br /> 131 r?b 81996 <br /> 81.997 41 <br /> -q 31�f- 819-98 - <br /> 000 <br /> 1996 _000 <br /> 0 <br /> L <br /> N <br /> 10 82001 <br /> e n e �y r ne ure <br /> Received ypTrna`ture <br /> I 'rte r p to <br /> Relinquished by (3ipnstut 1 Received by (Signature) � 7� t]ate/Tirne � <br /> Relinquished by ( gnature) Received by Mobile Laboratory for field analysis (Slpnature) UatelTime <br /> 01spatohed by (Signature) Date/Time Recel a for abor vey by d 1 rrlme <br /> Method or Shipment <br /> ■ Lrtborato� m� � � � � � <br /> a "G <br /> Special fnelructlans � <br /> ra <br /> eAilli PRESERVATION I hereby authorize the performance of the above Inilk work N <br /> A <br /> APPRMIRTr <br /> AEAD SPACE ABS NTS CONTAENERS <br /> . 1, <br />
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