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Environmental Health - Public
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EHD Program Facility Records by Street Name
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4602
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3000 – Underground Injection Control Program
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PR0521963
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Last modified
5/28/2019 4:02:10 PM
Creation date
5/28/2019 3:47:51 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3000 – Underground Injection Control Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0521963
PE
3030
FACILITY_ID
FA0014942
FACILITY_NAME
TRIPLEX RENTAL
STREET_NUMBER
4602
STREET_NAME
CHEROKEE
STREET_TYPE
RD
City
STOCKTON
Zip
95215
CURRENT_STATUS
02
SITE_LOCATION
4602 CHEROKEE RD
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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[ t [ t [ t [ L t t t [ [ t [ [ [ t [ <br /> Geological Tecluiics Inc. 1,r L 0l2 g Page of _F` <br /> 1101 7th Street VJ <br /> Modesto,CA Chain of Custody <br /> (209)522-4119 Fax 522-4227 <br /> E-mail:geologicaltechnics@sbcglobal.net Analysis Requested Laboratory Name and Address: <br /> Project#: Client/Project Name: <br /> VC2-9 ,� c�c�,rn r c��c�; 1�er c�1 • tea ri L. t— s <br /> Site Address: <br /> ca <br /> ukNo ib <br /> Remarks: Lab Purchase Order#: -1.53 t PJ <br /> m � <br /> Sarrpled By: (print and sign name) Turnaround Time. Standard ❑ASAP <br /> c o � <br /> � .T- ��- Q2 Hour ❑Other_ <br /> Date. Time Sample I.D. z° 2 v� Remarks <br /> vri-S 0 G P 4 - -) ' 15 <br /> oc1N5 G P s r - � I I's <br /> G G X <br /> Relinq ;shed : ( ign ture) Date: t3 Time: <br /> r T' 11 <br /> Relinq e i D Time: Recei ed by: (si atur b te: ime: <br /> Relinquishe : (sign tur D t : Time: Recoived by' ure Date:.1 2 �/-D ime: 1 S/t� <br /> Meake return cooler/ice chest to Geological Technics Inc. Rev.5/03 <br />
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