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ARCHIVED REPORTS_XR0010157
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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SHAW
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3500 - Local Oversight Program
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PR0545688
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ARCHIVED REPORTS_XR0010157
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Entry Properties
Last modified
5/21/2020 3:15:19 PM
Creation date
5/21/2020 10:15:28 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010157
RECORD_ID
PR0545688
PE
3528
FACILITY_ID
FA0003634
FACILITY_NAME
CANTEEN CORPORATION
STREET_NUMBER
1500
Direction
N
STREET_NAME
SHAW
STREET_TYPE
RD
City
STOCKTON
Zip
95205
APN
14326008
CURRENT_STATUS
02
SITE_LOCATION
1500 N SHAW RD
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
Scanner
LSauers
Tags
EHD - Public
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� AdvancedCHAIN OF CUSTOD*ECORD <br /> �9 9�7 <br /> GeoEnvzronmental, Inc. t Dace�Z—( 7-0? Page _� � <br /> 837 Shaw Road Stockton, California 95215 - (209) 467-1006- Fax (209)457-11 <br /> ClientProject Manager <br /> Tests Required <br /> Gr <br /> Phone Number <br /> Sample (Signature) �C"7 Invoice <br /> Project Name AGE <br /> � -, y <br /> e-q-n C 1R �,�.. �` Qent ❑ <br /> Samp a Type <br /> Sample Location Date Time Water Solid No of �a ,A- <br /> Number <br /> Grab 44 ti 899 ' <br /> Number Description Air Conts _�Y 44 <br /> f <br /> AD-43 z o 1 az 0 7+at /d3 e- x .3X 89945_ <br /> YlwZ/02070L 02-0 7v2- / 9,/ x 3 X Al X X 89946 <br /> /010 70Z X 3 XJX1 x A 89947 <br /> nl..i3A/o4 2orc,t0�1 -3 X X <br /> �JJ 89948 <br /> .j . <br /> 3 X -89949 <br /> way bZ o7Cz c�z�ro� /' /�a <br /> N"i -T/pZ 0702 tai 1XI X X 89950 -1, <br /> a inquisY ( ig ure} Receivedy Signature) --f , <br /> x �, K � dU <br /> Reim ed by Si e) Received by (Signature) Date ime <br /> ; <br /> Relinquished b (Signature) � r <br /> 4 Y weed b '�Ai�o i!e Lab-{}�atony f r field analysis (Signature) i Dale(Time <br /> 1 I <br /> Dispatched by (Signature) r +. 8 ,11 _,,+ �` D ime Received for Laboratory by D to ime <br /> Method of Shipment Laboratory Name <br /> Cu Ouer i P, <br /> Special Instructions i hereby auth ize the per ormance of the above indicated work <br /> x <br /> 1 <br />
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