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ARCHIVED REPORTS_XR0008900
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_XR0008900
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Entry Properties
Last modified
6/1/2020 2:36:15 PM
Creation date
6/1/2020 2:16:24 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008900
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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i . i l i i i i i i a i i I• � � <br /> ( Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date Page - of <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1116 <br /> Client Proj ane Tests Required- U <br /> Pone Number <br /> 6 L <br /> am rs (Signature) Invoice. <br /> Project Name AGE e <br /> op., Client ❑ <br /> Sample Location Sample Type No of <br /> Number Description Date Time Water Air Salld Cants Notes <br /> Comp Orab <br /> avlr 54fi9 <br /> �#-� r• <br /> 1! �„ 54fi20 <br /> 1 <br /> s i q sad igna raece ve y ignature U to [me <br /> F <br /> Relinquished by (Signature) Recelved by (Signature) I Date[Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Datefrime <br /> Dispatched by (Signature) Date/Time Re �raborat4 DalelTlme <br /> � //, <br /> Method of Ship m Laboro% N e <br /> Special Instructions I here y au't rize the PIF Drmance of th above Indicated work <br />
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