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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0506390
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Last modified
5/6/2019 1:33:42 PM
Creation date
5/6/2019 1:22:07 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0506390
PE
2950
FACILITY_ID
FA0007389
FACILITY_NAME
MINI STOP
STREET_NUMBER
244
Direction
W
STREET_NAME
HARDING
STREET_TYPE
WAY
City
STOCKTON
Zip
95205
APN
13708014
CURRENT_STATUS
01
SITE_LOCATION
244 W HARDING WAY
P_LOCATION
01
QC Status
Approved
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EHD - Public
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CHAIN OF CUSTODY'RECORD <br /> C4 <br /> - -�;r- GeoEnvironinental,.�xnc. `" p Date � ` e=ase I of <br /> 4005 Norah Wilson Way-Stocklon,California-95205 (209)467-1006-Fax(209)467=1 118 <br /> Client _ Project Manager / <br /> i R /LL_ C �TestsRequired <br /> A- � ... <br /> 17 <br /> Phone-Number <br /> ° Samp[[lers: (Signature)_ . <br /> y invoice: <br /> E� Project Name t r r U AGE <br /> Client- 0 <br /> ,Sam le Location Sample Type <br /> �No. of <br /> Date Time <br /> Number r Description . Water Air Solid Cents. Notes' <br /> Comp: Grata. <br /> �:r'-•�"wy— <br /> r6, <br /> r�i-,•r.t"a -+.. ..vv.'',. vr' � n-rL�__ter.'.} v -..rin'i '-.ie r,ar'..a+ ,x�_.�••Yla nom.'.__ .s. n....__'�r-x '-r'r 'il ra4n•1..ww ..v.'rwn..s rra.yr'.,. �, .ri:. wlv Y = n.'!ws-. .:reuv_ _—.M — f•'..�..-ji9.{'. ir--.. <br /> -p �. er .--yzr.•.� •— 9K .�- — — - — n r -- —��� --�. �.:.�,_�� �e a,—wm xrh` = z-, a—� x• —. ►-F�._g•��:= • <br /> r. <br /> ' • E ,. <br /> e,m rs a Slgnatwc a rve y: gnature~ 4�•—�3ste Dale/Time <br /> ck <br /> � , <br />{ Relinquished y: {Signature) Receive by,'(SignaRire) Dale(Tlme <br /> R©linquished by: (Signature) <br /> Received by:Mobile laboratory Far field analysis: (Signature) Date/Ttme'' <br /> Dispatched by: (Signature) ;, ' Date/Time Received for laboratory by: Date(Fime <br /> Method o1 Shipment' r' <br /> a .' R pry Na <br /> J��f1 <br /> .i 'Cabo al <br /> yrs ,� c, <br /> Special Instructions `r r�' n r <br /> -- )7�:SCt �',li��rJ� ' P hereby aul Drize th performance of the above Indicated-work. <br /> GOOD CONDITIRa <br /> -c.r'..'�� _� -,J... -. «.'=.`—.�-•,�` »�. �..:.�� .T, 1: �. ... f,..,.� _-:'.' 'x,� �-...L ��t�t� '. ''l'._._ uJ_� aF,-�.w#i..—,.cy�.-- � -� .---- <br /> F <br />
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