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ARCHIVED REPORTS_XR0008899
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_XR0008899
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Entry Properties
Last modified
6/1/2020 2:36:43 PM
Creation date
6/1/2020 2:15:49 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008899
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
Scanner
LSauers
Tags
EHD - Public
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Advarzced • CHAIN F CUSTOD*EUORD <br /> GeoEnviron mental, Inc. �c� Z ` , �; �l,L Date Page o>� <br /> 4005 North Wilson Way-Stockton,California-85205-(209)467 1006 ax(209)467 1118 <br /> Client Project Manager <br /> Tests Required <br /> P fine Number <br /> (. )C, <br /> /;� Sam I (Sr ature) Invoice <br /> Project Name / `+ AGE <br /> 0xa<�P- R- ct r2L�-'Vk- Client ❑ <br /> Sample Location Date Time Sample Type No of <br /> Number Description Water Air Solid Coats Notes <br /> cornp Grab <br /> •�• f F <br /> (. 6029"8 <br /> � E <br /> e inquis a ign re eceive y rgnature ate(Trme <br /> s' aO <br /> Relinquish by (Sig ature) Received by (Signature) Date(Trme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) 191 Date/Time <br /> I <br /> A 7 <br /> Dispatched by (Signature) Date/Time Retewed for Laboratory b Date/Time <br /> h <br /> Method of Shipment f" Laboratory N e <br /> n <br /> Special Instructions "`1� T IIiJE��I151�Q1ti1 I hereby autho the p r ormance of the above indicated work <br /> '�.! n L U <br /> Jr�t. 1 <br /> KAD SPACE ABSENT COKAINERS l• <br />
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