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ARCHIVED REPORTS_XR0008890
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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V
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VAN BUREN
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424
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3500 - Local Oversight Program
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PR0545786
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ARCHIVED REPORTS_XR0008890
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Entry Properties
Last modified
6/1/2020 2:49:10 PM
Creation date
6/1/2020 2:10:26 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008890
RECORD_ID
PR0545786
PE
3526
FACILITY_ID
FA0004969
FACILITY_NAME
CHASE CHEVROLET
STREET_NUMBER
424
Direction
N
STREET_NAME
VAN BUREN
STREET_TYPE
ST
City
STOCKTON
Zip
95205
CURRENT_STATUS
02
SITE_LOCATION
424 N VAN BUREN 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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�-T7 <br /> ReadwdEftft cHAN of CUSTODY RECORD Page ofr <br /> Envi=menfal and Geofechnrcal Consultant 555 Montgomery Street,Suite 1900,San Francisco,CA 94111 Ph 41"55-90401 Fax 415-955-0041 <br /> 2 Theatre Square,Suite 216,Orinda CA 94563 Ph 025.253-4980/Fax 925.253-4985 <br /> 501 1411h Street,3rd Floor,Olanak ,CA 612 Ph 510-874-45001 Fax 510-8744 <br /> Site Name S`�(x� � , � <br /> Job Number p Anal sls Requested' Q <br /> Project Manager%Contact M&pN j S V <br /> Samplers <br /> Recorder(signature Required) s v No Containers <br /> Matrix &Preservative t J � <br /> �j ; yuan'Field Samples *a-' <br /> � �� <br /> Identification No Hate �Ime Lab Sample No ; 1-"�. PPM. Renaarks4F �"S <br /> sljalb U 1 <br /> 4�3 3 <br /> j J 4&—7 -- I I I . I I I I <br /> I wsh 1'�I AkWgR �l I I I <br /> to ] pate )� ]me oived <br /> gnaltue} pate Tin <br /> hnqutshe by(St nature) Date Time gnature} pa Time <br /> Relinquished by,(Signature) Dale Time Received by Lab (Signature) Date Time <br /> Sent to Laboratory(Name) Method of Shipment Lab courier Fed Fir E:Agbome UPS <br /> Laboratory Comments/Notes Hand Carned❑Pnvate Courier(Co Name) <br /> White Copy-Original Yellow Copy-Laboratory Pink Copy-Field COC Number 003312 <br />
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