My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
ARCHIVED REPORTS_XR0004955
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
M
>
MOSSDALE
>
444
>
3500 - Local Oversight Program
>
PR0545585
>
ARCHIVED REPORTS_XR0004955
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
9/16/2020 12:03:54 AM
Creation date
3/19/2020 3:24:33 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004955
RECORD_ID
PR0545585
PE
3528
FACILITY_ID
FA0000212
FACILITY_NAME
Mossdale Chevron
STREET_NUMBER
444
Direction
W
STREET_NAME
MOSSDALE
STREET_TYPE
RD
City
LATHROP
Zip
95330
CURRENT_STATUS
02
SITE_LOCATION
444 W MOSSDALE RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
62
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
( Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc Date Page ( of 2- <br /> 4005 <br /> 4005 North Wilson Way-Stockton,California 95205-(209)467-1006-Fax(209)467-1118 <br /> Client Project Manager <br /> L Tests Required <br /> Phone Number <br /> Samplers. (Signature) 4a Invoice <br /> Protect Name <br /> l7 r AGS <br /> Client ❑ <br /> Sample Location SampleType <br /> Number Description Date Time Water Air Solid No of Conts Notes <br /> Comp Grab <br /> MOT— I aro 4,9310- $ <br /> 49112 . <br /> 49313 <br /> �I�nqulsh!e y ign t o ece ve y ignature <br /> DatelTrme <br /> Relinquished by (Signature) Received by (Signature) <br /> Datefrime Relinquish-ad by (Signature} Received by MoWle Laboratory for field anaiysls (Signature) <br /> Date/Time <br /> Dispatched by (Signature) Date/time He i ed for Labor o by /t7 DatelTime <br /> Method of Shipman Laboratory Name 03 16 00 aa,-) <br /> Special Instructions r <br /> Mrs �fh��� i hereby authorize the performance of the above indicated worts <br /> i , ii,r`�I I ills _ I' ,'P1P , L <br />
The URL can be used to link to this page
Your browser does not support the video tag.