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SITE HISTORY_CASE 4
EnvironmentalHealth
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3500 - Local Oversight Program
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SITE HISTORY_CASE 4
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Last modified
5/12/2020 3:53:58 PM
Creation date
5/12/2020 3:19:45 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE HISTORY
FileName_PostFix
CASE 4
RECORD_ID
PR0545660
PE
3528
FACILITY_ID
FA0003909
FACILITY_NAME
PORT OF STOCKTON
STREET_NUMBER
2201
Direction
W
STREET_NAME
WASHINGTON
STREET_TYPE
ST
City
STOCKTON
Zip
95203
APN
14503001
CURRENT_STATUS
02
SITE_LOCATION
2201 W WASHINGTON ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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LSauers
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EHD - Public
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GeoAnal fical Laboratories Inc. <br /> ENViR�'INI' ENT4 HFALTH _ <br /> 1031 Kansas A%-e_ ph0qkM_)596MJ <br /> Modesto. California 95331 Fax #(209) X72-091 <br /> -_ 5367 <br /> CHAIN OF CUSTODY <br /> Client��.'� r Gl,r�(� Phone <br /> Address CC to: <br /> Zip <br /> re <br /> U <br /> 4 <br /> PROJE"T I o. ANALYSIS <br /> Of <br /> con <br /> SAMPL BY: (signature) lain- �r <br /> ers a / `� REMARKS <br /> ipie <br /> /1y4 I Sample ID 1. � <br /> 1J2te ��;�e�;,,�o <br /> P,720?" 0 <br /> i i t I I I l l <br /> i <br /> I I I I i l l i I <br /> Relinqu;sned by (signature): Date Time Received by(signature): Date I Time <br /> Reiinyuisned {signa ur..t. Date Time I Received by{sign ure): I Date Time + <br /> I' Date 1 Time <br /> reliny;s-edy{signature): I Dat Time Received d y{signature): ; <br /> Rel+nqu++sneaky (Signatures: Date <br /> Time Received by{sign ): Date Time <br /> IReiinou,snec Dy (signature; I Date i Time Received by (signature): Date Time <br /> I I <br /> I Site Tir, s: <br /> I Driving Time: <br /> Start: Finish: Total ;Hours: ! Start: Finish: Total hours: <br /> Mileage _ 1 J - — Approved By'I <br /> '� L b� �`°v'^{���^+r / IJ r•iry is 4� j <br /> 1 <br />
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