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ARCHIVED REPORTS_XR0008902
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_XR0008902
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Entry Properties
Last modified
6/1/2020 2:43:10 PM
Creation date
6/1/2020 2:20:18 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008902
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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EHD - Public
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• <br /> CHAIN OF CUSTODY RECORD <br /> { Advanced <br /> GeoEnvironmentai, Inc, g73 271 0 . <br /> Date Page of <br /> • <br /> 4005 North Wtls n Way-Stockton,California-95205-(209)467-100209)467-1110 <br /> Client Project M ger Tests Required <br /> • <br /> P ne tlumber <br /> ©0 <br /> a rs fgnature) Invoice <br /> J AGE di' <br />� Pro)ect Narne � / � ��`��--�� lR./[C`.�_�v'/ Client ❑ <br /> Sample Location Date Time SamWaterple Type $olid No of Notes <br /> Number Description Camp arab Air Conts <br /> AA <br /> ' I 36 7 g7 <br /> rVor 110 �1rA �rl s <br /> roll , <br /> e in ur a r n lure Receivedy (Signature) Date/Tims <br /> V—UL <br /> Relinquished by (SignatureN Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Palo/Time <br /> i © f•A <br /> Dispatched by (Signature) DatelTrme Recaivgd for LabMI/aboratory <br /> tbte/Time <br /> Method of Shipment am <br /> Special Instructions � �? h !LZ 70 I hereby authorize the parti of the above indicated work <br />
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