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ARCHIVED REPORTS XR0011653
Environmental Health - Public
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2900 - Site Mitigation Program
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PR0521409
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ARCHIVED REPORTS XR0011653
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Entry Properties
Last modified
6/20/2019 1:50:13 PM
Creation date
6/20/2019 11:46:36 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0011653
RECORD_ID
PR0521409
PE
2950
FACILITY_ID
FA0014531
FACILITY_NAME
PLYMOUTH ROAD STORM DRAIN PROJECT
STREET_NUMBER
0
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
CURRENT_STATUS
01
SITE_LOCATION
0 COUNTRY CLUB BLVD
QC Status
Approved
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EHD - Public
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rr r� ■Ir �r r� ■r �r ,r r rr �r rr r r r rr rr r r <br /> CYN-OF-CUSTODY <br /> ConAr Earth Technologies, Inc.10 <br /> 21663 Brian h+ne 91 188 Frank West Circle, suar-1 <br /> NO_ 6368 PO Box 3905 /Sonora California 95370 Stockton CA 95206 <br /> Q 209-532 0361 209-234 0518 <br /> V 209-532 0773 (fax) 209-234 0538 (f Lx) <br /> 2 Lf h ! / � 7— m1oC'condoremh corn condor Ccondorstock[on cam (e-rnajl) <br /> 1-4 SHIPPED T4. l SEND RESULTS TO <br /> NAME v `03 <br /> a, <br /> OFFICE /c�n Cir Sri <br /> [,1 PLEASE FAX RESULTS p� PROJECT f5r a Sra�l�fi f/I Q C Tr L4 t,pre <br /> PROJECT NO � � 7 ff � <br /> NOSti`� ✓ Verificationto SANIPLED BY of ti <br /> (Signature) con- �Q <br /> tarn- 4' <br /> M Date Time Sample ID ers <br /> U) � REMARKS MISC <br /> ;OL' y1 6A-6 1 - q i7 0 <br /> NI?Lj M' 'I <br /> `Y7 0 oC� y -� 2- X <br /> 9/11/011 0-'0 0 176A-6P3-V1c 3��s <br /> 17 v ! '4 ® y176/3-G -9 7 a a A �� '��L( <br /> a 3 It 10 _G o c� <br /> V17/8'51 0-30 �11.4 <br /> 00 <br /> Z G <br /> Cf, <br /> o <br /> Relinquished S I D tc Time _ Rzccttied By M <br /> t <br /> CE (5t nature) �7 Q 3 3�i (S�gnaiure) Time <br /> `�`'�� 3 ",o : Relinquished By Date Time Received By(Sinature) <br /> (Si rtnluCE Relinquished B) daReccive(I By <br /> (Signature) (Signature) <br /> Ot iglttaE Send Yellow-File <br /> tl Pink-Log Book <br />
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