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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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t <br /> IBMIIEll <br /> INTERNATIONAL <br /> TECHNOLOGY <br /> CORPORATinN CHAIN-OF-CUSTODY RECORD R/A Control No. . 3[kl 1 <br /> PROJECT NAME/NUMBER ?gAf4dh'1 C/C Cortfro!Na. 50702 <br /> LAB DESTINATION /'1AG wt� JK <br /> � <br /> SAMPLE TEAM (MEMBERS ��_ <br /> CARRIER/WAYSILL NO. h't CJGY � i <br /> Sample <br /> Number sample -, <br /> Location and Description Dete and Time SS Sample j 1 <br /> _ Corttainar-0—1 Collected Type Type Condllla7 on Recelpt Disposal iT <br /> —U-Z .,Q�) (Nemo and Date) <br /> Svj �r�sS Record No. <br /> T <br /> S T=j- ¢ rv�' 0 925 <br /> 5 0%0 <br /> 5 T-0—6 ' <br /> 0 S <br /> Special Instructions., <br /> ossible Sample Hazards: y, <br /> SIGNATURES: (Na a.C <br /> n , D a and Time) t m <br /> 1: Relinquished$yZ t -L T Car <br /> Received ey: ��_, I 3. Relinquished By: <br /> Received by: <br /> 2. Relinquished$y; � <br /> 4. Relinquished By: : <br /> Received By: . <br /> Received By: :. <br /> -. .. <br /> ITE-1 Mpal Plan <br /> YELLOW.Fhldc <br /> rw h .. - % <br />
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