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SITE HISTORY_FILE 1
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2801
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2900 - Site Mitigation Program
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PR0504943
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SITE HISTORY_FILE 1
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Last modified
6/17/2020 4:03:28 PM
Creation date
6/17/2020 3:13:16 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE HISTORY
FileName_PostFix
FILE 1
RECORD_ID
PR0504943
PE
2951
FACILITY_ID
FA0004032
FACILITY_NAME
AMERICAN MOULDING & MILLWORK (FRMR)
STREET_NUMBER
2801
STREET_NAME
WEST
STREET_TYPE
LN
City
STOCKTON
Zip
95204
APN
11709001
CURRENT_STATUS
02
SITE_LOCATION
2801 WEST LN
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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IIIIYYY' .� Client <br /> DEL SAIVIP�E CHAIN OF CUSTODY RECORD Address �`'� 'I <br /> GeOtechnical Support Services (please Print) phone No. 333 <br /> Proj. MgrXontect 1A) <br /> 10624 Olive Avenue <br /> Oakdale Calif. 95361 Pink-Field Copy <br /> White and Yellow-To laboratory with Samples ' <br /> (209)847-8757• Rekord _. of Yellow-Retum to Client <br /> PROJECTISITE NAME: Jgbk WES% ANALYSIS.REQUESTED <br /> PROJECTICONTRACTIPO NO.: AQ <br /> NAME OF SAMPLER: REMARKSISPECIAL INSTRUCTIONS <br /> }. <br /> LAB USE ONLY ShMOLF0NUMBER <br /> LAB I.D.., I.D. TE TIME pp CON- <br /> O TAINERS <br /> No. '20746 <br /> GOOD Comm WOW <br /> sow <br /> saw <br /> .r <br /> r� <br /> RELINQUISHED BY SIGN DAT EmME If RE BY SIGN' _.... 7' -'-DATEITIME RECEIVED FOR`LABORATORY <br /> ] DATFrIME <br /> .r BY(SIGN): . <br /> RECEIVED: <br /> ti O <br /> ❑ LD AND INTACT &kR PRESERVATIVE 'DYES ONO <br /> OTHER' <br /> TURN AROUND TIME: <br /> O Day <br /> SHIPPED VIA: OFED X ©UPS 'OTHER: SHIPPING ORDER NO.: 024-Hi .02-Day, P5-Day {I <br />
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