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2900 - Site Mitigation Program
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PR0542676
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COMPLIANCE INFO
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Entry Properties
Last modified
12/2/2020 11:18:44 AM
Creation date
7/27/2020 9:04:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0542676
PE
2953
FACILITY_ID
FA0024554
FACILITY_NAME
JOHNS, WILLIAM D
STREET_NUMBER
1640
Direction
N
STREET_NAME
BROADWAY
STREET_TYPE
AVE
City
STOCKTON
Zip
95205
CURRENT_STATUS
01
SITE_LOCATION
1640 N BROADWAY AVE
P_LOCATION
01
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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Advanced GeoEnvironmental, Inc. www.advfzeoenv.com CHAIN OF CUSTODY RECORD <br /> ❑837 Shaw Road,Stockton,California 95215 •Phone(209)467-1006 • Fax(209)467-1118 Date: /—/-7—/'[ Page I ofL <br /> ❑381 Thor Place,Brea,California 92821 •Phone(714)529-0200•Fax(714)529-0203 <br /> 2318 Fourth Street,Santa Rosa,California 95404 • Phone 707 570-1418 •Fax 707 570-1461 <br /> = - ❑ ( ) ( ) Analysis Required <br /> F] 395 Del Monte Center,#111,Monterey,California 93940 •Phone(800)511-9300 •Fax(831)394-5979 <br /> El <br /> Project Name /� / Project Mana er / <br /> OiGL` �r- t vc �.k <br /> Client Sampler(initials&signature) <br /> r�1 <br /> L <br /> 5- <br /> Invoice to: ❑ AGE ❑ Client <br /> Lab Project No.. <br /> Sample ID/Location/Description Date Time Matrix Number Notes <br /> S 5LIJ- (IJ -r7-1.� -7. I �(, <br /> t 1 ., <br /> s - - qp ; 3e <br /> V0 VL <br /> Relinquished Date: Time: Laboratory: <br /> Courier: Received by: Date: Tirae: <br /> Relinquish by: Date: Time: Received by: Date: Ti . <br /> Relinquished by: Date: Time: Received by: Date: Time: <br /> Requested Turn Around Time(circle): 24 hours 48 hours 72 hou 5 days(standard) ther: Matrix Codes: A=Air W=Water S=Solid <br /> Special Instructions to lab: I hereby authorize the performance of the above indicated work. <br /> !Geotracker EDF to: geotracker@advgeoenv.com ❑ <br /> Global ID: /, <br />
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