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ARCHIVED REPORTS XR0001535
Environmental Health - Public
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EHD Program Facility Records by Street Name
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C
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CHARTER
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1419
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3500 - Local Oversight Program
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PR0544465
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ARCHIVED REPORTS XR0001535
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Entry Properties
Last modified
5/16/2019 1:34:48 PM
Creation date
5/16/2019 1:20:44 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0001535
RECORD_ID
PR0544465
PE
3528
FACILITY_ID
FA0005837
FACILITY_NAME
STEFANOS GASOLINE*
STREET_NUMBER
1419
Direction
E
STREET_NAME
CHARTER
STREET_TYPE
WAY
City
STOCKTON
Zip
95205
APN
15137016
CURRENT_STATUS
02
SITE_LOCATION
1419 E CHARTER WAY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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SJGOV\wng
Tags
EHD - Public
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RECORD <br /> Advanced <br /> Advanced <br /> � <br /> CHAIN OF CUST09 <br /> __-- J— <br /> GeoEnvironmental, Inc. Date — ��Page Of-4-1 � <br /> 937 Shaw Road- Stockton, California- 85215 - (209)467-1006 - Fax(209)467-1118 <br /> Client 1 Prof anager Tests Required <br /> Phone Number <br /> Samplers (Signature) - Invoice, <br /> AGE <br /> Protect Name 1_�lO Client ❑ <br /> �J 1� <br /> Sample Location Date Time Sample Typic Solid No of N. <br /> Notes <br /> Number Description Water CoAir ContCamp Grab <br /> Itt° <br /> 00 �r <br /> HEAD SpACHAB! NT <br /> CONTAINS <br /> DECHLORINATE ITN LAB PttCSERVEI [N LAB <br /> v <br /> rREsvtvAT'0 <br /> qu s e y rgnature ace ve y gna ure Datefrime <br /> e mquishe <br /> d by (Signature)) calved by (Signature) Date/Time <br /> Relinquished by (Signature) Recelved by Mobile Laboratory for field analysis (Signature) Qate(Time <br /> r <br /> I <br /> Dispatohed by (Signature) Date/Time Re boralory y /�� s 9 �C <br /> OP <br /> Method of Shipment Laboratory N /// 7 <br /> Special instructions &IN`�'ACT VIA�^�_ I he authorize the performance of the above Indicate work <br /> � 1 <br />
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