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ARCHIVED REPORTS XR0000953
Environmental Health - Public
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EHD Program Facility Records by Street Name
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BROOKSIDE
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1621
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3500 - Local Oversight Program
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PR0544129
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ARCHIVED REPORTS XR0000953
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Entry Properties
Last modified
2/11/2019 5:23:22 PM
Creation date
2/11/2019 4:28:42 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000953
RECORD_ID
PR0544129
PE
3528
FACILITY_ID
FA0001719
FACILITY_NAME
SUSD-STAGG HIGH SCHOOL
STREET_NUMBER
1621
STREET_NAME
BROOKSIDE
STREET_TYPE
RD
City
STOCKTON
Zip
95207
APN
11009004
CURRENT_STATUS
02
SITE_LOCATION
1621 BROOKSIDE RD
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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X885 Jarvis Drive <br /> -MMorgan Hill, CA 95037 • (408) 776-96OU • HAx (4Ud) itis b;�Ud <br /> FAX (916) <br /> 21- <br /> 34- <br /> ID OQUOIA ANALYTICAL ❑ 404 N.Wiget LQ 819 Striker aii Walnut Creek, CA 94598- (92) 988-9600921-9600 <br /> 6FAX 925) 88-9673 <br /> ❑ 1455 McDowell Blvd. North, Suite Q • Petaluma, CA 94954• (707} 792-1865 FAX (707) 792-0342 <br /> CHAIN OF CUSTODY <br /> 0 1551 Industrial Road • San Carlos, CA 94070 • (650) 232-9600 FAX (650) 232-9612 <br /> Company Name: /fTG s 'G Project Name: s�S f f� �{ �7,ZgZ,ZJ004 <br /> Mailing Address: 1//7 Lorze- ve_ S('; g Billing Address (if different): <br /> i <br /> City: !Uo c State: Zip Code:9535/ <br /> Telephone:Zr)9_ FAX #:�j -S7 - P.O. #: T <br /> Report To: Sampler:X� o . d ❑ Level C ❑ Lel B�� OC Data: .Level D (Standar ) eveevC1 Level A U <br /> p �yrr L v �er��h x <br /> Turnaround 10 Working Days ❑3 Working Days ❑2 -8 Hours ❑ Drinking Water Analyses Requested d <br /> Time: ❑ 7 Working Days ❑ 2 Working Days ❑Waste Water <br /> 1� � ti <br /> ❑ 5 Working Days ❑24 Hours a���� .RMther6 W <br /> a <br /> Client Date/Time Matrix # of Cont. Sequoia's ���— <br /> Comments <br /> Sample I.D. Sampled Desc. Cont. Type Sample # <br /> , ll '#o w�I <br /> 1. w— j 031500 f W nI o <br /> Cr <br /> a� <br /> 2. cn <br /> 3 I r L4 <br /> 4. <br /> 5. <br /> 6. <br /> m <br /> 7. 0 <br /> _ <br /> Q <br /> p Q1 <br /> U. <br /> 9 t <br /> 10. <br /> , 3 c� Time: /. <br /> Relinquished By: �, f Date: b3lffl0p Time: 133() Received By: Date: lU <br /> Relinquished By: <br /> Date: Time: Received By: /¢1ff ate. (,, dU Time: - D.E�J <br /> ✓f <br /> Relinquished By: Date: Time: Received By Lab: Date: Time: <br /> Were Samples Received in Good Condition? ❑Yes 0 No Samples on Ice? 0Yes ❑ No Method of Shipment / Page l of l <br />
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