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3500 - Local Oversight Program
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PR0545686
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Entry Properties
Last modified
5/21/2020 9:30:20 AM
Creation date
5/21/2020 9:27:39 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
WORK PLANS
RECORD_ID
PR0545686
PE
3528
FACILITY_ID
FA0003565
FACILITY_NAME
UNIVERSAL SWEEPINGS SERVICES
STREET_NUMBER
1113
STREET_NAME
SHAW
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
14327042
CURRENT_STATUS
02
SITE_LOCATION
1113 SHAW RD
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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Advanced CHAIN OF CUSTODY RECORIJ, <br /> GeoEnvironmental, Inc. Date 2 Page I of Z <br /> 837 Shaw Road-Stockton,California-85215- (209)467-1006- Fax(209)467.1118 <br /> ClientProject Manager <br /> CUn verse \ wee t'r, (�AIr2 Tests Required <br /> Phone Number <br /> ` Imroice: <br /> Sampler&1nW1ure) �'r y D` ` �' <br /> Project Name '� ok (� D Client - <br /> U'. N; V0_r�.cJ � eeyJ-0,�< <br /> Sample Location SamA 7VOe No. of k4s <br /> Date Time Water Solid L Notes <br /> Number Description Air Conts. <br /> Comp. Grab. <br /> UST- Z — j_ C 0, CSI'.I 4-2.-(J--S ILA-548 XJ <br /> UST-z -w weir t(�zsal i`i`IL X <br /> 1ST-\— F [ASS u:�lerz r� lLkgj X X X <br /> D- 1 (Xr`S2t5e: r��a rt <br /> LA St <br /> dX z 5Cs3 JC 1� M <br /> e a y: gnat a ecerve y: ignature a e Ime <br /> f ��L <br /> R q d by: (Signature) Received•by: (Signature) •` TIirY,C� J Date/Time. <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: Date(Tima <br /> Method of Shipment; /� �� Laborato Name Cal Te <br /> Special Instructions: I hereby a orize the performance of the above indicated work. <br /> --o O"'4 SAce-t Srvr (Socrecf. <br />
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