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ARCHIVED REPORTS XR0001584
Environmental Health - Public
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EHD Program Facility Records by Street Name
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C
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CLAY
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639
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3500 - Local Oversight Program
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PR0544513
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ARCHIVED REPORTS XR0001584
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Entry Properties
Last modified
6/14/2019 1:00:09 PM
Creation date
6/14/2019 10:23:50 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0001584
RECORD_ID
PR0544513
PE
3528
FACILITY_ID
FA0024115
FACILITY_NAME
WEST CLAY PROPERTY
STREET_NUMBER
639
Direction
W
STREET_NAME
CLAY
STREET_TYPE
ST
City
STOCKTON
Zip
95209
APN
14707110
CURRENT_STATUS
02
SITE_LOCATION
639 W CLAY ST
P_LOCATION
01
QC Status
Approved
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SJGOV\wng
Tags
EHD - Public
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Advanced CHAIN OF CUSTODY RECORD <br /> - _ GeciEnvironmental Inc. Date 5,-;_ 7'q 7 Page L of 2- <br /> of Nol7heril Ccllrfontta -7 X P X �GE a 6`� <br /> 1803 West March Lane,Suite A-Stockton,California-95207-(209)9560264-Fax(209)956-0700 art �° ra• t �;_,,- ;1 <br /> Project Manager76954 ' <br /> or <br /> Client W.,5T (_ C" Fro L.rT Tests 9 � � <br /> SKr <br /> Phone Number ^ ' `•} �G 955 - t <br /> �-aq)g5 (-02b �l ri "•ai FY' r .�rt649,56l <br /> Samplers (Signature) .� Q• I � � crs}h ~� <br /> a <br /> Project Name \Arx5-r L a PnorpY�` �A1 �_' Client � <br /> y r o <br /> Sample Location Sample Type No ofr� <br /> Number Description Date Time _ Water Solid ���• �� � �r g�� lir, <br /> Comp Grab Air COntS <br /> M w14 S" X r f <br /> V, �wrl/fi-'�>T^Q7 ^f Jr 171 ).46 <br />�� � <br /> W r lrw <br /> �l mw=3 L; _q -'(J X 5 Xx Y� <br /> of t j EV - -I / S'' 7-q �r-V V x 5 <br /> Im MW-s ��-� -17 :� X 5 XIX <br /> e in is e y (Signature) eceive y (Signature) DatelTrme <br /> Relinquished by(Sidnaturer Received by (Signature) Date(Trrne <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> r <br /> Dispatched by (Signature) Date/TimerReceived for Labor toy bye �yt -7rl DatelrEme <br /> 121, j'}')�} Il - rn <br /> Method of Shipment �[ ) � Laboratory Name�� <br /> C I' OY Vtoi ver — 11c'Ca <br /> Special Instructions I hereby authorize the performance of the above indicated work <br /> �'��!O��hnDlrni2�� APPROPRIAT12 <br /> y <br />
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