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ARCHIVED REPORTS XR0001713
Environmental Health - Public
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EHD Program Facility Records by Street Name
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C
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CHEROKEE
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16
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2900 - Site Mitigation Program
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PR0522479
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ARCHIVED REPORTS XR0001713
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Entry Properties
Last modified
5/17/2019 2:59:15 PM
Creation date
5/17/2019 2:36:00 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0001713
RECORD_ID
PR0522479
PE
2957
FACILITY_ID
FA0015299
FACILITY_NAME
GEWEKE LAND DEVELOPMENT & MARKETING
STREET_NUMBER
16
Direction
S
STREET_NAME
CHEROKEE
STREET_TYPE
LN
City
LODI
Zip
95240
APN
04323013
CURRENT_STATUS
01
SITE_LOCATION
16 S CHEROKEE LN
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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Advanced �` ' _-=�� CHAIN OF CUSTODY RECORD <br /> "c ,3 f <br /> GeoEnvironmenta , hic Date Page of <br /> 837 Shaw Road - Stockton, California 95215 - (209) 467 1006 - Fax (209)467-1118 <br /> Client _ Pro ect Manager Tests Required <br /> one Number <br /> '?�1 7 10 C' <br /> Samplers (Signature) , Invoice <br /> Project Name _ �✓ AGE [a <br /> Client ❑ <br /> Sample Location Sa ple Type No of � �r�� � <br /> Number Description Date Time Water Solid !� Notes <br /> Comp Grab Air CDniS t <br /> t'a ter 7 <br /> AA Q <br /> 1,2 q5 <br /> /J J <br /> l5-2- — <br /> fuytAJI IVUW I E 'I LZMw I <br /> C — <br /> -1eTin us e agnature eceive y (Signature) DalelTima <br /> linqurshed by (Signature) Received by (Signature) DatelTrme <br /> Relinquished by { NDp _ pf PItpPR 401eit1 by Mobile tahoraiory for field analysis (Signature) Dalefflma <br /> READ SPACEABSENT CONTAINRRS— <br /> T(12 IN ATE <br /> , <br /> UINI&R—MMIRY PJA LAII <br /> Dispatched b (Signature) Dete/Time Rec rvedlfor Laboratory DalelTlme <br /> g> Y g VOA Dk(3 M11TALS QiHHR <br /> PAESSRVATIOM <br /> Method of Shipment t _ laboratory Name <br /> Special Instructions }� 1 here y authorize the parfotmance of the above Indicated work <br /> / �` c s�!A_REC'D-aCALM&JNTAGT-VJft <br />
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