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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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635
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2900 - Site Mitigation Program
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PR0506770
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Last modified
1/31/2019 9:47:03 PM
Creation date
1/31/2019 1:33:15 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0506770
PE
2950
FACILITY_ID
FA0007617
FACILITY_NAME
HICKINBOTHAM BROS (FORMER)
STREET_NUMBER
635
Direction
S
STREET_NAME
AURORA
STREET_TYPE
ST
City
STOCKTON
Zip
95202
APN
14730004
CURRENT_STATUS
01
SITE_LOCATION
635 S AURORA ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date PaW <br /> ' Of Northern Califomi t <br /> TM WOO March Lame,Sufh A-Stockton.Callbrnia-9=7-(209)9580264-Fax MM 9680700 4 <br /> Client Project Manager <br /> ` Required <br /> n ` Phone Number <br /> Samplers: Signature) ice; <br /> Project Name !lq AGE <br /> U§JALA., Clem ❑ <br /> Sample LocationSample Type <br /> Date Time Water Solid No.of Notes <br /> Number Description Comp. Grab. Air Com. <br /> X83 77 row X 70400 <br /> F <br /> 83-ur 78401 <br /> 2' b q30 0 ttF4 H 7840 <br /> 78403 j <br /> •— r �� oft <br /> ' it <br /> 78404 <br /> s inqu y: qna a y: (51qna ure R 7• �' <br /> • Z61141 A) ( 7917 <br /> Ra nqu a y: ( gn u e) ad by: ($IgnaIda) Date/'hne <br /> Relinquished by: (Signature) Received by Mobile Laboratory for lield analysis:(Signature) Datettitne <br /> Dispatched by: (Signature) DatelTime lReceivedfor Laboratory by: Datellrltne <br /> Method of Shipment, � _ Labor C Netr� I <br /> Special Instructions: I hereby authorize the arformance of the above Indicated work. <br />
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