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ARCHIVED REPORTS_XR0012084
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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W
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WILSON
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101
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2900 - Site Mitigation Program
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PR0541653
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ARCHIVED REPORTS_XR0012084
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Entry Properties
Last modified
10/10/2020 11:07:03 PM
Creation date
7/9/2020 8:40:25 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012084
RECORD_ID
PR0541653
PE
2965
FACILITY_ID
FA0023871
FACILITY_NAME
TOP FILLING STATION
STREET_NUMBER
101
Direction
S
STREET_NAME
WILSON
STREET_TYPE
WAY
City
STOCKTON
Zip
95205
APN
15125307
CURRENT_STATUS
01
SITE_LOCATION
101 S WILSON WAY
P_LOCATION
01
QC Status
Approved
Scanner
LSauers
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EHD - Public
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Advanced CHAIN OF CUSTODY RECORD <br /> GeciEnvironmental, Inc. Date jy-� Z Page <br /> 837 Shaw Road- Stockton, California- 95215- (209)467-1006 - Fax f209) 467-1118 <br /> Client <br /> F Project Manager <br /> - , <br /> .' ) rr, �' ' y!- Tests Required <br /> Phone Number 4 <br /> p � ,mow , <br /> j , <br /> Samplers (Signature) r ' Invoice <br /> AGE ❑ <br /> Project Name 1 7 - to _ � . <br /> Client ❑ <br /> Sample Type <br /> Sample Location No of <br /> Number Description Date Time Water Air Solid Conts �: ' `"� Notes <br /> Comp Grab 2 <br /> to <br /> f <br /> d <br /> NO _ t ° <br /> y _ f <br /> r+ Fi <br /> e mquis e y (Signature) _ Received y (Signature) ate/Time <br /> ✓ ! "Z V xy <br /> RetinquSshed by (Signature) Received by (Signature) Dateffime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) �, Dateffime <br /> i <br /> Dispatched by (Signature) Dateffime Received for Laboratory by Dateffime <br /> Method of Shipment F Laboratory Name <br /> 4%%%%Insuuctwns 1 hereby authorize the performance of the above indicated work 1 <br /> r <br /> J � <br /> r ` <br /> s, <br />
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