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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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BYRON
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12750
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3500 - Local Oversight Program
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PR0544143
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Last modified
2/13/2019 2:32:52 PM
Creation date
2/13/2019 2:11:42 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0544143
PE
3528
FACILITY_ID
FA0004719
FACILITY_NAME
CALDRONS GENERAL STORE
STREET_NUMBER
12750
Direction
W
STREET_NAME
BYRON
STREET_TYPE
RD
City
TRACY
Zip
95376
CURRENT_STATUS
02
SITE_LOCATION
12750 W BYRON RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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CHAIN OF CUSTODY RECORD � <br /><- la*_- Geological Audit Services Inc . >�. <br /> Envirra�rmenra Pin/ess�+ona/s Date /O- L�}-74--page _I of <br /> vMEWtaOJ West March Lane,Sults A•Stockton,California-95207-(209)956-0264 1 <br /> 313.3AGAsss a <br /> �.frA Pro'ect Manager <br /> enc � Ca ldroh Tests Required- <br /> Phone Number <br /> r <br /> 4: <br /> Sam rs: (Signat re) - Invoice: <br />)ject Name , 64 I Jro k , Mar Fi-e C GeoAudit l <br /> Client Q <br /> S� a Location Sample Type <br /> Date Time No.of `C <br /> Number Description Water Air Solid Cents Notes <br /> Comp. Grab. <br /> 7PW <br /> a- 94 lull�I-L <br /> 13:16' 4184113* 10 <br /> 41842 <br /> 41843 <br /> Mn, Pecs Dy:(Signature) <br /> y: (Sign Oale/Tf'me <br /> ;e� r <br /> wry �YLc� 10- 01100 7lid A&T/W b t, <br /> Iinquished by:(Signature) wed by: (Signature) :e <br /> linquished by:(Signature) Received by Mobile Laboratory for field analysis:(Signature) <br /> OateTme <br /> tpatched by: (Signature) Date/Time Received for Laboratory by: Dalen;me l <br />►thod of Shipment: 1 tt Laboratory N me - <br /> T1"a r<s a c —��i' �eCe i Jeol 151-�T C <br /> racial Instructions: 1 hereby thori2e the performance of the above indicated work. ' <br /> - ti <br /> y _, •�� <br /> 1 l 1 l 1 1 ] 1 1 1 1 1 1 l 1 1 ) 1 l <br />
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