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ARCHIVED REPORTS_XR0005001
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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MONTE DIABLO
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2650
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3500 - Local Oversight Program
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PR0545577
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ARCHIVED REPORTS_XR0005001
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Entry Properties
Last modified
9/16/2020 12:28:53 AM
Creation date
3/19/2020 1:55:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005001
RECORD_ID
PR0545577
PE
3528
FACILITY_ID
FA0003836
FACILITY_NAME
LOCAL FOOD MARKET
STREET_NUMBER
2650
STREET_NAME
MONTE DIABLO
STREET_TYPE
AVE
City
STOCKTON
Zip
95203
APN
13311131
CURRENT_STATUS
02
SITE_LOCATION
2650 MONTE DIABLO AVE
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc, *A' <br /> Date—1(24-( Page of <br /> 837 Shaw Road - Stockton, California- 952115- (209) 467-1006 Fax ( 09) 467-1118 <br /> Client LV(-AL- 7 TO f-or, Project Manager <br /> ���L Tests Required <br /> LI I+ Ce'I Phone Number <br /> Samplers (51 nature) Invoice <br /> Project Name <br /> L$C,,AL FdP f "rDa. U�L �� AGE �- <br /> � � Client ❑ <br /> Sample Type <br /> Sample LocationDateof <br /> Number Description Date Tlme Sam Water Air Solid Corns Notes <br /> comp Ora b <br /> 84256_ <br /> IM,w 3 (-26-0 p o 'C - - - -84258 <br /> 0 = 3b k K /V 84259 <br /> qu a Racalvea by' gna urs <br /> _7 DatelF ma <br /> efinqu s e y (Signature) Recelved by (Signature) Dati !Time <br /> el nqu shed by S gnature Received by Mobile Laboratory for field analysis (Signature) DatatTime <br /> Dispatched by (Signature) Dalemme Race veo for Laborat y b ate(Time <br /> Method of shipment <br /> L boralary Name <br /> CINL <br /> voAs tA[rALs OND %G <br /> i Special Instructions _ o t above indicated work <br /> 1 its aulh ix the <br /> ROOD CONUTION APPROPRKIFE <br />
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