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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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AIRPORT
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30836
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3500 - Local Oversight Program
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PR0543385
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Last modified
10/24/2018 7:17:16 PM
Creation date
10/24/2018 2:17:16 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0543385
PE
3528
FACILITY_ID
FA0002988
FACILITY_NAME
JIMMYS ONE STOP
STREET_NUMBER
30836
Direction
S
STREET_NAME
AIRPORT
STREET_TYPE
WAY
City
TRACY
Zip
95376
APN
24116002
CURRENT_STATUS
02
SITE_LOCATION
30836 S AIRPORT WAY
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
WNg
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EHD - Public
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GeoAnalytical Laboratories, Inc. <br /> 1031 Kansas Ave., Suite C Phone (209) 572-0900 <br /> Modesto, California 95351 Fax #(209) 572-0916 <br /> CHAIN OF CUSTODY 17 7 <br /> Client «- ��lSLC1 _� _—W 'hone <br /> Address CC to: <br /> Zip—. _. <br /> — FROJECT ID i ANALYSIS — <br /> No. <br /> at <br /> SAMEBignature) ers REMARKS <br /> . p e <br /> Date Time type Sample Location �Yj <br /> 11 eb G�ma 'Z��l a <br /> --moi - -�-- J __�� 3s <br /> i i -- <br /> Rel qui e by (si atur at Time ! R ei (si t e): ate Time <br /> inquished by (signature): Date Time Received by (signature): Date Time <br /> Relinquished by (signature): Date Time Received by (signature): Date Tirne <br /> I <br /> — ! <br /> Relinquished by (slgnature) Date Time Received by (signature): Date Time <br /> Relinquished by (signature): Date Time Received by (signature): W Date Time <br /> Site Time: Driving Time: <br /> Start: Finish: Tctai Hours: Start: Finish: Total Hours: <br /> Garoh Graphics(204)527-3667 — <br />
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