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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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BROADWAY
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1610
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2900 - Site Mitigation Program
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PR0524303
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Last modified
2/11/2019 3:29:27 PM
Creation date
2/11/2019 2:51:49 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0524303
PE
2950
FACILITY_ID
FA0016297
FACILITY_NAME
ARMOUR & BONNIE SMITH 2003 TRUST
STREET_NUMBER
1610
Direction
N
STREET_NAME
BROADWAY
City
STOCKTON
Zip
95205
APN
14325008
CURRENT_STATUS
01
SITE_LOCATION
1610 N BROADWAY
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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Geological Tec%ics lfic. Page of �' r <br /> 11017th Street <br /> Modesto,CA Chain of Custody <br /> (249)522-4119 Fax 522-4227 <br /> E-mail:gti@geologicaltechnies.com Analysis Requested <br /> Laboratory Name and Address: <br /> Project#: Glient/Project Name: <br /> 12.t <br /> Site Address: J_- <br /> [ <br /> � .� �7�.1 . <br /> ' 44 <br /> c5 r=� r Purchase Order# <br /> Remarks.: - <br /> _ -0 EDF Report: ❑ Yes 1 No <br /> Sa d 8y:(print .nd sign name) o p c <br /> ��, cl w o Turnaround Time: S=Standard <br /> j ° 'c .o 1day, 2 day, 5 day <br /> �f <br /> ate Mme Sample t.D. z 2i "` �' Remarks <br /> i ov- o9=t ? Is I'S VJX 1Y_1 <br /> 9th SG-3 Lj, 73;� ,5.4 <br /> 35.5 <br /> 11.15- -t_L <br /> .S6 2c, -TD,S �.aS <br /> -�lS <br /> Reiinquis by: (signature) Date: Time. R ived by: (signature) Date: Time: <br /> r <br /> /4-h/0 <br /> Re qui§ b (signatur � Dat <br /> ` : Time: eceive by: D t Time: <br /> R inquished by: (signat e) Date: Time: Received by:.(signature) Date: Time: <br /> Please return cooler/ice chest to Geological Technics Inc.. <br /> Rev. 12103 <br />
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