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ARCHIVED REPORTS XR0003333
Environmental Health - Public
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EHD Program Facility Records by Street Name
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D
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DA VINCI
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4627
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2900 - Site Mitigation Program
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PR0543804
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ARCHIVED REPORTS XR0003333
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Entry Properties
Last modified
6/28/2019 3:53:44 PM
Creation date
6/28/2019 2:40:08 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003333
RECORD_ID
PR0543804
PE
2950
FACILITY_ID
FA0024907
FACILITY_NAME
7-ELEVEN STORE #20632
STREET_NUMBER
4627
STREET_NAME
DA VINCI
STREET_TYPE
DR
City
STOCKTON
Zip
95207
CURRENT_STATUS
01
SITE_LOCATION
4627 DA VINCI DR
P_LOCATION
01
QC Status
Approved
Scanner
SJGOV\wng
Tags
EHD - Public
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Phone# 916-753-9500 HAIN OF -CUSTODY RECORD AND ANALYSIS REQUEST <br /> 1046 olive Drive Suite 2 Fax# 916-753 6091 <br /> k weste)1)E nwonrnenial Davis CA 95616 Sample Receiving# 916-757 0920 �� <br /> 1 ° Sc,arue G Technolugy _ _ _ _ _��_-- -- -- - For <br /> Project Manager --- -�� -� --- Plane # � ANALYSIS REQUEST s ' Lab <br /> / _ II I Use <br /> k, <br /> :T"c `� c �r������- ------ _���� �=cZ7C'o—__-- -- --I r� - EE c,4 l I kQ YONLY <br /> -- FAX# i J _I- I <br /> Corn anylP,rcldres�G rL f S'(E oYnt{,/� ! I ; I <br /> Far tiro N <br /> -Ste <br /> Project Nuhiber P O Of Pro ect Name <br /> c 7 — _ ��G f ( (LGk�Lr —C__ p � <br /> O — Y <br /> Z071�D`f7� L Sampler nature 4 r <br /> prolect l ocaU0) d ' <br /> 1 - Lo <br /> CO Z � <br /> Method I — ° N ' <br /> Sampling Container p G " 1 <br /> Matrix ro �f o �, �� '' L u <br /> 1 (Type/Arnounl} Preserved N v o w ,� u' <br /> ,) S a m p e I D --- -F ---_ ,,U-� - a - - <br /> Y �� Ill li! —) N w o � Cl u <br /> DATE TIME `� iia UZu� O +� O i- ►"'- � a � 0. � u ,�,� <br /> O -r ° _ = U Z 3; 6 mca ►- ji)iujw i <br /> ' V) _ il- IL <br /> `/ffs <br /> PL <br /> f -I /,P,-I !�J <br /> - - �_ _� <br /> + V I�l ! IJ 1 t _l l _1_ k l�1--1_ � - I k <br /> k P, I 1 I Il I k lob{ ,tUi f i <br /> Relnark5 U <br /> 'r'' + squish y 7te Time R eived by <br /> ` <br /> R it quisl>ed y D' le Time <br /> Received by <br /> 120 <br /> 1., <br /> +i) Relinquished by Date Time Received by LaUorala pill o <br /> f <br />
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