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ARCHIVED REPORTS_XR0008305
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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WATERLOO
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4407
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2900 - Site Mitigation Program
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PR0535375
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ARCHIVED REPORTS_XR0008305
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Entry Properties
Last modified
7/7/2020 9:21:25 AM
Creation date
7/7/2020 9:17:13 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008305
RECORD_ID
PR0535375
PE
2960
FACILITY_ID
FA0020405
FACILITY_NAME
ERNIES GENERAL STORE
STREET_NUMBER
4407
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
08710059
CURRENT_STATUS
01
SITE_LOCATION
4407 E WATERLOO RD
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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( Advanced CHAIN OF CUSTODY ECORD <br /> GeoEnvironmental, Inc. Date 9 '/&' 0I Page Of31- <br /> 837 <br /> 837 Shaw Road- Stockton, California 95215-(209)467-1006- Fax (209)467-1118 <br /> Client ` Sr Project Manager <br /> n 7 1 A, Tests Required <br /> Phone Number <br /> Samplers (Signature) 0 Invoice <br /> Protect Name � �' � �� <br /> AGP <br /> Client ❑ <br /> Sample Location Sample Type No <br /> Number Description Date Time Water Air Solid Conts, Q Notes <br /> !I (�ff��y/ Comp crab <br /> `�-5-ol fV rAA-1II 77639 ' <br /> I� 77640 <br /> i 77641 <br /> i+Iqj <br /> 77642 <br /> l <br /> e mqure e y gnat aFlOcalved by gna u e <br /> ate/Time <br /> Re inquis a by (Si Received by (Sig alur.I <br /> Dale/Time <br /> _ff <br /> efinquFs hog by ( gnature} Received by Mobile Laboratory for field analysis (Signature} <br /> Dale/lime <br /> Dispatched try (Signature) Dalattime Received or aboratoryyy. <br /> Method of Shipment — <br /> i Laboratory game <br /> Special Instructions 31 c i „ ( thereby authorize the performance of the above indreated work <br /> �F <br /> VIP<„f'lit _ w <br />
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