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ARCHIVED REPORTS XR0012588
Environmental Health - Public
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EHD Program Facility Records by Street Name
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C
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COUNTRY CLUB
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1403
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2900 - Site Mitigation Program
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PR0505513
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ARCHIVED REPORTS XR0012588
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Entry Properties
Last modified
6/20/2019 5:05:37 PM
Creation date
6/20/2019 3:39:30 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012588
RECORD_ID
PR0505513
PE
2950
FACILITY_ID
FA0006438
FACILITY_NAME
United # 5446
STREET_NUMBER
1403
Direction
W
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12323246
CURRENT_STATUS
02
SITE_LOCATION
1403 W COUNTRY CLUB BLVD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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, <br /> i 7 <br /> Nil <br /> • 11 <br /> NMMPN UM <br /> INTERNATIONAL, <br /> TECHNOLOGf< R/A Control No.2� <br /> CORPORATION CHAIN-OF-CUSTODY RECORD <br /> 7}4 O� C/C Control No. 197996 <br /> PROJECT NAME/NUMBER Ute` A ,.,_� 1� .�� LAB DESTINATION --I -L� <br /> SAMPLE TEAT t^h-/1 <br /> M MEMBERS f 1 `� CARgIER/WAYBtLL NO. <br /> Sample Sample Date and Time Sample Container Condition on Receipt Gie ggal '' <br /> Number Location and Descrfption <br /> Collected T <br /> ype Type (Name and Date) Record No. <br /> 141Q L [ T, <br /> IAsI°,. a J. �. <br /> :•., `' ; <br /> ti y <br /> .4 <br /> II .. <br /> - <br /> I�45 <br /> Special Instruct ions:aftaP <br /> �t <br /> ossible Sample Hazards: 1� L4 I h C,[�n. {t•L4 1 V\ �vta rl 1 <br /> SIGNATURES:', (Name,Comp ny,Dat a d Time) C_-Y <br /> 1. Relinquished By:, Z 10kIv 0 3. Relinquished By: <br /> r is <br /> Received By% YD �i I <br /> Received by: <br /> 2. Relinquished)By: 4. Relinquished By: <br /> Received By:: Received By: <br /> - - WHITE-To fly any nflmples - - -- <br /> K <br /> YELLOW-Flel <br /> r ... <br /> I <br />
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