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ARCHIVED REPORTS_XR0008290
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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SCHOOL
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107
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3500 - Local Oversight Program
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PR0545674
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ARCHIVED REPORTS_XR0008290
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Entry Properties
Last modified
5/20/2020 10:14:59 AM
Creation date
5/20/2020 9:55:48 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008290
RECORD_ID
PR0545674
PE
3528
FACILITY_ID
FA0006039
FACILITY_NAME
MARK NEWFIELD
STREET_NUMBER
107
Direction
N
STREET_NAME
SCHOOL
STREET_TYPE
ST
City
LODI
Zip
95240
CURRENT_STATUS
02
SITE_LOCATION
107 N SCHOOL ST
P_DISTRICT
004
QC Status
Approved
Scanner
LSauers
Tags
EHD - Public
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CHAIN F CUSTODY RECORD <br /> � Advanced � � � •� � <br /> GeoEnvironmental, Inc ( Dared Pageof <br /> 837 Shaw Road Stockton, California- 95215 - (209)467-1006- Fax (209) 467-1118 <br /> Client Prate anag <br /> / Tests Required <br />� l <br /> P no N tuber <br /> bog e76 <br /> s {Si nature) Invoice <br /> Project Name AGE <br /> JL > Client ❑ <br /> Sample Location Samp a Type , <br /> Date Time Water Sajid No of NotesNumber Description comp crab Air Corns <br /> m vis e { natur ecT�e Gaa y gnatureDate(Tims <br /> R Iingkrish d y (Signa r Received by (Signature) Date/Tlme <br /> Retinqvished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> TA <br /> Dispatched by (Signature) Date/Time Re or Laboralor <br /> �(y1Z Datefflme <br /> Method of Shipment RECD SEALED&INTACT V14 EMe IL- (t Laboratory Nam <br /> special Instrucllona APPI hereby au ixe tfr rformanc the above Indicated work <br /> itOPRIA7'$ r <br /> HEAD SPACE At35BTiT ---- Cl]NF <br /> DECHL,0RINATED IN LAB PRESEIIVEA <br /> v1:1r+,RRVATT0X <br />
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