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ARCHIVED REPORTS XR0001673
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 XR0001673
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Entry Properties
Last modified
6/14/2019 1:21:20 PM
Creation date
6/14/2019 11:05:25 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0001673
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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EHD - Public
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ttttt�e ■i■� tflflflflfls i, � � fi_ i, i, � � � � � � � � � <br /> Advanced CHAIN OF CUSTO*ECORD <br /> GeoEnvir©nmental, Inc. <br /> Date T-22-CS" _ Page I_ of--L <br /> 837 Shaw Road-Stockton, California- 95215- (209)467-1006- Fax(209) 467-1118 Q <br /> Client a�n S [vim n , �„ , Project Manager + ' t Tests Required <br /> Phone Number <br /> C2oi) '4Gfl-- Iooc- <br /> Samplers (Signature) `� � Invoice <br /> \hjf �bC AG E <br /> Project Name ec �1a�r -�,P y , Client ❑ <br /> Sample Location Sample Type No of <br /> Date Time Water Solid �Z ,fur Notes <br /> Number Description Comp crab Air COr1tS �, <br /> i <br /> W-M-Eq CPT-11 40-Rgh 'RI tfi S?y' 9-22-05 5112 X X <br /> T1?--1,9-10 f Chi--IZ 92' 1 Id � <br /> X <br /> rT 7-- }SZ-)S UT-1Z 1 2'� )�5 �3�t� s <br /> )T12-127,-)'95 CSIT-)?- 1$2' t J4 S� � is <br /> e+nquise y +g lure) ece+ve y ignature <br /> elmqu+ahed b (S+gnature) Received by (Signature) <br /> �- t7ata(r+me <br /> ST T A. �� <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatelTime <br /> Dispatched by (Signature) Date/Time Received for Laboratory by ©atelTima <br /> rX Y� <br /> Method of Shipment 'Laboratory a G°+I <br /> Special Instructions I hereby authorize the performance of the above Indicated work <br /> �rZ� <br />
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