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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 r <br /> 2795 2nd Street,Suite 300 <br /> /FF Davis,CA 95616 <br /> Lab: 530.297.4800 <br /> ANALYTICAL eec Fax: 530.297.4808 Lab No. 33` D Page of L <br /> Project Contact(Hardcopy or PDF To): California EDF Report? Yes ❑No <br /> �eo t��"--e4 Chain-of-Custody Record and Analysis Request <br /> Company/Ad ess: G P=MnWxbd but not aftsedion: <br /> Sampling Company Log Code:JZ <br /> � [� G/� Analysis Request a <br /> No.: FAX No.:/ Global ID: m x <br /> m so m <br /> Project NumberP.O, No: EDF Deliverable To(Email Address): m <br /> C3 w N V <br /> Project Name: Sa n re `� $ �, m w ti N a O <br /> CL <br /> Project Address: � a az o :Jr M <br /> Sa piing Con Preservative Matrix o W y r4 ; M r <br /> La <br /> z mn r` !t cA cm0. <br /> ao n <br /> nation 0ate Time <br /> N <br /> O <br /> > o m m v sLL <br /> z <br /> Sig Sample Deo o m <br /> tr) <br /> J u7 <br /> h -I <br /> �/A/ L'3 _i2 <br /> �rilD e f 7C <br /> 7 7 <br /> —T- <br /> or <br /> I J <br /> :Fi <br /> TFFF <br /> Relinquished by: Date Time Received by: Remarks: <br /> Z <br /> Relinquishe ate Time Received by: <br /> I <br /> I <br /> Relinquished by: Dale time Recei by Lab tory: Bill to: <br /> Zj� taro �; t9*�t Ly 'CiLQ <br /> DistrtbuUon: White-Lab, pink-06ginator Formslcoc 121 Oo1 Ih9 <br />
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