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ARCHIVED REPORTS XR0006144
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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1856
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3500 - Local Oversight Program
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PR0544589
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ARCHIVED REPORTS XR0006144
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Entry Properties
Last modified
6/21/2019 11:44:04 AM
Creation date
6/21/2019 9:40:59 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006144
RECORD_ID
PR0544589
PE
3528
FACILITY_ID
FA0001909
FACILITY_NAME
STOP N SHOP
STREET_NUMBER
1856
Direction
W
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
123-191-02
CURRENT_STATUS
02
SITE_LOCATION
1856 W COUNTRY CLUB BLVD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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SJGOV\wng
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EHD - Public
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{ Advanced CHAIN OF CUSTODY RECORD <br /> - GeoEnvironmental, Inc. Date 1? Page --/- ofd_ <br /> 837 Shaw Road- Stockton,Calitornia- 85215 - (209)467 1046 Fax (209)467-1118 <br /> Client Project Manager <br /> r� Tests Required <br /> Phone Number , <br /> '?p al <br /> Samplers (Signature) Invoice <br /> Project Name AGE,,K <br /> Client <br /> Sample location —95mpkType No of <br /> Date Time <br /> Number Description comp Grab Air Solid corns Nates <br /> 88292 <br /> 88293 <br /> 88294 <br /> 88295 <br /> a nqu a y ignatt e) ece va y gnature t(i lP/oz pale im <br /> 3_ CYNA tl-e/L C 'SG "`d o0 <br /> Ra inq y S ur Received by (Signature) �" Date iiia <br /> Relinquished by (Signature) Received by Mobile Laboratory lot field artaiyers (Slgnature) Data/Tima <br /> Dispatched by (Signature) atalTlme Receive nr laboratory by nale/Tlme <br /> Mell.od of Shipment Laboratory flame <br /> LIZ <br /> Special Instructions 3 ! herebya rixe lha_p o{mance the above indicated work <br /> PRESERVATION <br /> WDC CGNDITIf -' _ AP l?0RIATE <br />
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