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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0516708
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COMPLIANCE INFO
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Entry Properties
Last modified
6/15/2020 2:29:06 PM
Creation date
6/15/2020 2:25:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0516708
PE
2950
FACILITY_ID
FA0012750
FACILITY_NAME
ROBERTS METAL INC
STREET_NUMBER
1803
Direction
S
STREET_NAME
STOCKTON
STREET_TYPE
ST
City
LODI
Zip
95241
APN
06219017
CURRENT_STATUS
01
SITE_LOCATION
1803 S STOCKTON ST
P_DISTRICT
004
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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j Advanced CHAIN OF CUSTODY RECORD <br /> 2- �0/ Page <br /> --- GeoEnvironmentaL Inc. •;' +� �, pate oof <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 <br /> Client Pro'ect Mana er <br /> �D$E�7�S f����S Tests Required <br /> `N W. M�9rs --- <br /> Phone Number <br /> Samplers: (Signature) �� ' �� Invoice: <br /> Project Name <br /> Proi' 13Le7S ���� J6T (� } �D <br /> Client <br /> LS Aug 1 ��,./ ` <br /> . .... . .... . <br /> Sample Location a Date Time Solid Sample Type No. of � � 5 9 9 8 5 <br /> Number Description Water Air Conts. Y �7 <br /> Comp. Grab. N <br /> / �- 59986 <br /> "�J— �ugc/WFS'T 4F �jGl/Lj�'itCCr" OZ•4$`6( �I�d� xx <br /> 59987 <br /> t2-/0 <br /> -lam wzo tic r r��e-D <br /> s 6+S-r OAK /A( 64'((- �•�/� Jo �/ k I � � � 59988 <br /> P3-S- <br /> 1 <br /> Rel nqui y. i r - eceive y: Ognature Date/Time <br /> p2-12 d�/�Zd7 <br /> Reli quished by: (Signature) Received by: (Signature) <br /> 57AalD r//. 7 I 59989 <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(Signature) <br /> 59990 <br /> T)ispaiched by: (Signature) Date/Time Received for Labor4 or:by: y <br /> 59991 <br /> Method of Shipment: Laboratory Name <br /> CAL ©vW1107- M' ti-INW 4 <br /> Special Instructions: U� AS 0&G �! _ 1 hereby authorize the perfo ance of the above indicated work. <br /> p PRESERVATION 'MLS OT <br /> CONDITIO APPROPRIATE �. — <br /> HEAD„PACE ABSENT Ctk�Tn <br />
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