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ARCHIVED REPORTS XR0006117
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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1876
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2900 - Site Mitigation Program
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PR0542421
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ARCHIVED REPORTS XR0006117
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Entry Properties
Last modified
6/21/2019 1:21:41 PM
Creation date
6/21/2019 10:45:40 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006117
RECORD_ID
PR0542421
PE
2950
FACILITY_ID
FA0024377
FACILITY_NAME
COUNTRY CLUB BLVD/295950
STREET_NUMBER
1876
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12319101
CURRENT_STATUS
01
SITE_LOCATION
1876 COUNTRY CLUB BLVD
P_LOCATION
01
QC Status
Approved
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SJGOV\wng
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EHD - Public
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2795 2nd Street, Suite 300 <br /> [I(tANA <br /> i �YTICA <br /> Davis,CA 95616 <br /> J/- L.4LC Lab: 530.297.4800 <br /> Rax: 530,297.4808 Lab No.Asa�A page^�of� _ <br /> Project Contact{Hardcopy or PDF To): California FDF Report? ❑ Yes o <br /> 0 &-,e Chain-of-Custody Record and Analysis Request <br /> Company/Addrwxlod <br /> p J^ ampling Company Log Code: Analysis Request <br /> Phone FAX No.. <br /> 3U GloballD; _ v <br /> m <br /> a �— � 7� m <br /> Project Number: .0. No: co ' rUi <br /> Et}F oil <br /> To(Email Adtlro4;s): 0� m <br /> m m ?{ }C Q CD X 1 <br /> Q ur Ill W M C <br /> Project Name: Sampler Signal 9 U l m r a m <br /> W W c� $ a - w o L a <br /> Project Address: x x a "' <br /> /� in <br /> �r'p Sampling ContaiPreservative Matrix g o a a 0 <br /> o `� <br /> U. <br /> E u! O z F- X a ro CD <br /> Sample Designation Oate e ? ox <br /> M <br /> > J N <br /> CG- ti S -3 o� <br /> Relinquished by: D Time Received by: Remarks: <br /> SIA <br /> / pRelinquis y: Time Received by: <br /> Relinquished by: Date Time Recel ed byL oratory: Bill to: <br /> loqVOS11310-1 K'4 4mlp(4 <br /> Distribution: Ift to-Lab, Pink-Originator <br /> Fvrrnsicoc 4211101.1h9 <br />
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