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ARCHIVED REPORTS_XR0010294
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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SHAW
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1500
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3500 - Local Oversight Program
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PR0545688
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ARCHIVED REPORTS_XR0010294
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Entry Properties
Last modified
5/21/2020 3:09:59 PM
Creation date
5/21/2020 10:16:30 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010294
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
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LSauers
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EHD - Public
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• • T <br /> ( Advanced CHAIN OF CUSTODY RECOR6 <br /> - = GeciEnvironmental, Inc, Date Page <br /> 837 Shaw Road - Stockton, California-95215 - (209)467-1006- Fax (209) 467-1118 <br /> Ghent Pr ct Manager <br /> AM el Mel-- Tests Required <br /> Phone Number <br /> Sam ers (Si nature) Invoice, <br /> Project Name AGE <br /> E g" <br /> Client ❑ <br /> Sample Type <br /> Sampie Location Date Time Water Solid No of Nrn�s <br /> Dumber Description CoAir Conts <br /> mq Grab <br /> 83236 <br /> 5 <br /> l <br /> f f <br /> '3 .� w© 83237 <br /> 83238 <br /> A-- 1 T <br /> e t q is ed 'Sign tura Receivedy ignature D to me <br /> Rel quished by ( ignature} Received by (Signature) DatelTirne <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatelTime <br /> Dispatched by (Stgnature} DatelTime I Received for Labbtato Y �1el7glrp <br /> telTline <br /> Method of Shipment Laboratory game <br /> f<h C 7N <br /> Special Instructions nr� r � � i hereby outh Ire the p rformance of the above indicated work <br /> 14 <br /> CCS f T <br /> GOOD CONDITION ,t,.' <br />
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