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ARCHIVED REPORTS XR0001365
Environmental Health - Public
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EHD Program Facility Records by Street Name
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C
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CENTER
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1201
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3500 - Local Oversight Program
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PR0544188
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ARCHIVED REPORTS XR0001365
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Entry Properties
Last modified
2/27/2019 3:15:14 PM
Creation date
2/27/2019 11:42:30 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0001365
RECORD_ID
PR0544188
PE
3526
FACILITY_ID
FA0006698
FACILITY_NAME
FERNANDOS PLACE
STREET_NUMBER
1201
Direction
S
STREET_NAME
CENTER
STREET_TYPE
ST
City
STOCKTON
Zip
95209
APN
14716003
CURRENT_STATUS
02
SITE_LOCATION
1201 S CENTER ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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� I• I• tt� � � t� � � t#� f� f� 11ff� � t1l!■■ 1tft� tttttttti■ tt�■w� <br /> � Advanced <br /> CHAIN OF CUSTOD%ECORD <br /> GeoEnvironmental, Inc. Date Z's 1)Y- Page .3 of <br /> 837 Shaw Road -Stockton, California-95215- (209)467-1006- Fax (209) 467-1118 <br /> JAllVJ '0 <br /> Project Manager <br /> Client . 1i <br /> Tests Required <br /> Phone (Number <br /> Samplers (Signature) Invoice <br /> hFF <br /> Protect Name r � AGE <br /> �fJJ,i.+ v.S /G c� � v Client <br /> Sample Type <br /> Sample Location Date Time —Water Solid No of Notes <br /> Number Description Air Conts <br /> Comp Grab <br /> M-11 0L;�PkW9 t-- 11Y 1 1 3 f l <br /> µm f( kw9 b 1166 A/ l /l / <br /> kta3A 132-Z, A/ /I / <br /> `' o 311U3 l l <br /> e is a ignature <br /> �nAecewe y ignature f)atellime <br /> .2--76 <br /> Re quashed by (Signature) Received by (Signature) Date[Time <br /> F Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature} Date/time <br /> / 172L,/ <br /> Dispatched by (Signature) Dateltrma Recawed for Laboratoryby Date/time <br /> Method of Shipment �Vm*, <br /> ne- <br /> SIP061ii, <br /> lnstruct�ot►s � _ / !� +�f � I hereby thorizs the performance of the above Indicated work <br /> r/Cc�+J e <br />
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