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ARCHIVED REPORTS_XR0012096
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_XR0012096
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Entry Properties
Last modified
10/10/2020 11:15:31 PM
Creation date
7/9/2020 8:47:18 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012096
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
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LSauers
Tags
EHD - Public
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�■■. ■■■f�,tl"■y Z,500 <br /> ( Advanced <br /> CHAIN OF CUSTODARECORD <br /> GeoEnvironmental, Inc. Date Page S of <br /> 837 Shaw Road -Stockton, California- 95215-(209)467-100$- Fax (209)467-1118 <br /> Client �AJ Project Ma����lTests Required <br /> Phone Number 1�f <br /> 4o /90, <br /> Sam p rs (Signature) Invoice <br /> A <br /> Project Name r� ' J AGE <br /> r I ► (J�C�Ti ®,.� <br /> Client ❑ <br /> Sample Location Sample Type No 01 , <br /> Number Description Date Time Water Solid ►v Notes <br /> Comp Grab Air CiontS <br /> o bra \/ W IG ti l3 <br /> V W a o$.Ue"3 A 1237 <br /> quis e y i nature Received y pnature <br /> Date/Time <br /> A7'3 /&V <br /> �nquashed by (Signature) Received by (Signature) Oats/Time <br /> Relinquished by tSignature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Date/Time <br /> Method of Shipment Lab ory m <br /> 71-1 <br /> k <br /> Special Instructions �y �� I hereby Ihorize the performance of the above indicated work <br />
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