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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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EHD - Public
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i i • <br /> 2795 2nd Street, Suite 300 <br /> .�� Davis,CA 95616 <br /> Lab: 530.297,4800 <br /> ANALYTICAL ccc Fax: 530.297.4868 Lab lJo. L43 4D Page�of <br /> Project Contact(Hardcopy or PDF To): California EDF Report? Ye8 C7 No Chain-of-Custody Record and Analysis Request <br /> Y Y <br /> r <br /> Company/Add ss: <br /> mpling Company Log CwL— r-� Analysis Requost 14- <br /> Phone <br /> P ne .. FAX No.: Global ID: <br /> Ca GGZc� U4 <br /> Project Number: P.O.No: EDF Dellvemble To(Ernatl Addrouo): o <br /> C3 U,M � o <br /> Project Name: Sam pl Sig to Ui L w m � �. o <br /> Project Address: /,r (� ampiing Contains Preservativ© Matrix m i5 A V w <br /> (pK a f� L145 oSf.��/. o gi m o N r ti <br /> z a a o o <br /> Sample Designation Data Time N = m m r 5 w <br /> t / -cit <br /> 10 <br /> ZZ <br /> 03 <br /> Y/I Oaf/Of d °y <br /> 45- <br /> L ac1 <br /> Z,Q �( •p"j <br /> / /' 09 <br /> � 7 z <br /> ats v 4 . lG <br /> Relinquished by: Date Time Received by: Remarks: <br /> 2/ <br /> Relinquishe r to -lme Received by: <br /> Relinquished by: Date Time Relved by boratory: Bill to: <br /> 210C ,310 <br /> Distribution: Wkita-Lab, Pink-Originator FprrnsltOC d 21001,Ih9 <br />
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