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COMPLIANCE INFO_PRE 2019
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PR0526861
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COMPLIANCE INFO_PRE 2019
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Entry Properties
Last modified
5/4/2021 3:28:40 PM
Creation date
5/4/2021 3:25:08 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0526861
PE
2950
FACILITY_ID
FA0018192
FACILITY_NAME
JOHN RAY CO
STREET_NUMBER
2205
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95209
APN
11911017
CURRENT_STATUS
01
SITE_LOCATION
2205 WATERLOO RD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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SJGOV\dsedra
Tags
EHD - Public
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Advanced <br />GeoEnvironmental, Inc. <br />CHAIN OF CUSTODY RECORD <br />Date 2 Li01 Page 2- of <br />837 Shaw Road - Stockton, California - 95215 - (209) 467-1006 - Fax (209) 467-1118 <br /> <br />Client 140,4110.- n Vail Vieet, LL(2. Project Manager <br />Tests Required <br />2."cber.1- Fictri-t, <br />Phone Number / <br />Project Name 3ohyi ea, (1-apcimi <br />Samplers: (Signature) <br />/. <br />Invoice: <br />Ifa CO , <br />AGE <br />ei42/60 <br />77,5ctec C <br />lat <br />lient ri <br />-, <br />Sample Location Sample Type <br />No. <br />/.4,/ <br />Number Descron Date Time Water Solid of 11 Notes * Comp. Grab. Air Conts. <br />( <br />6 Q-10 aj I aort vie./ 6 -3- 0 <br />ia .i.- .2,-14-01 . X 1 lo Id <br />6 -Z3 6 :; g ici ii- 9 --so -0 i '3.9 c <br />13j - 36 A) 6) .50 4 2,- 24:, -6-7 i 3 i 0. `e< I 140 LI <br />Ilitrit—.. C'd <br />N- CO 8,2 rei) 0 c4- 9......, A -i I ',./5-1) `7Z I 146 id <br />Relin uis ed by: (Signature) (... <br />C i4e..'... <br />Received I:nr - (Signature) Date/Time <br />2- 2 1-til i j (030 <br />elinq ished b : (- - - ; re) Received by: (Signature) en . ...... <br />4.--7-R-11C; <br />Date/Time <br />Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) 01.4 LI -Ta r 0 fAy-o-lir- Date/Time <br />Dispatched by: (Signature) Date/Time Received for Laboratory by- 2 1,9 Date/Time <br />: <br />Method of Shipment: <br />(1-.0.1 OVOrniC1114- <br />Laboratory Name, <br />Cell -Rein <br />Special Instructions: ...I <br />EDP lit rn -cdaiVrkiicevaii.coryi <br />I hereby authorize the performance of the above indicated work. <br />.„-- - g, /
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