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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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PR0523277
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Last modified
5/17/2019 9:18:52 AM
Creation date
5/17/2019 9:17:13 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0523277
PE
2950
FACILITY_ID
FA0015722
FACILITY_NAME
DELTA VALLEY TOWING
STREET_NUMBER
1919
Direction
E
STREET_NAME
CHARTER
STREET_TYPE
WAY
City
STOCKTON
Zip
95205
APN
15514004
CURRENT_STATUS
01
SITE_LOCATION
1919 E CHARTER WAY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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j L Advanced CHAIN OF CUSTODY RECORD <br /> " GeciEnvironmental, Inc. Date toPage of 2 <br /> 837 Shaw Road -Stockton,California- 95275-(209)467-1006- Fax (209)467-1178 <br /> Client & fD Project Manager lJ <br /> Tess Required <br /> Phone Number <br /> 09 44 -7 -/P <br /> (� Samplers: (Signature) a\ Irnroice: <br /> Project Name 7 ( I/ (/ AGE <br /> P/ C(ien <br /> Sample Location Sample Type <br /> Date Time Water Solid No. of Notes <br /> Number Description Comp. Orab. Air Conts. <br /> (31 - 5" ( %<�� 1 ►o- lZ 9'•'{S -/- I <br /> al- to <br /> 4►- 15' 9 .55 <br /> �r-c' <br /> �► - 35 11' 15 )C got, <br /> e mgur had by: t nature ecema y: (Signature) <br /> Data/Time <br /> 10-12-OY �c'•OOwti <br /> Relinquished by: (Signature) Received by: (Signature) Date/Tirne <br /> 2 K I�r. T <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: LJj Date/Time <br /> Method of Shipment: t�# La try <br /> o Name <br /> p r V'UN,c0.�al— r <br /> Special Instructions: 1 hereby <br /> /authorize the performance of the above Indicated work. <br />
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