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ARCHIVED REPORTS_XR0002520
Environmental Health - Public
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EHD Program Facility Records by Street Name
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G
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GRANT
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308
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2900 - Site Mitigation Program
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PR0542014
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ARCHIVED REPORTS_XR0002520
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Entry Properties
Last modified
1/16/2020 6:07:44 PM
Creation date
1/16/2020 4:21:06 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002520
RECORD_ID
PR0542014
PE
2960
FACILITY_ID
FA0023306
FACILITY_NAME
LARRYS AUTO REPAIR
STREET_NUMBER
308
Direction
N
STREET_NAME
GRANT
STREET_TYPE
ST
City
STOCKTON
Zip
95205
CURRENT_STATUS
01
SITE_LOCATION
308 N GRANT ST
P_LOCATION
01
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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� �� tlltltlllll■ 1_ itttllttt� Il♦ � 1• � � I• � � � � � � <br /> Advanced CHAIN OF CUSTODY ECORD <br /> GeoEnvironmental, Inc. Date -27-f 7 Page —�— of—� <br /> of Nor7hrna Calrfomia <br /> 1803 Wesl March Lane,Suite A Stockton,California-95207-(209)956.0264 Fax(209)956-0700 q E 3a <br /> Client t Project Manager <br /> It"vitTests Required <br /> kev;tl Mt; f l r�D Cir <br /> Q � � Phone Number <br /> !�� <br /> f l 7— 006 <br /> Samplers (Signature) �4. Invoice <br /> Project Name df,ryl! � G AGE 604"-r7 \, i <br /> � r Client <br /> Sample Location Sample Type No of I ' <br /> Number Description Date Time Water Air Solid Conts Notes <br /> Comp Grab <br /> KM W " I V-2 7 - 1 -7 1U z7 rT X V�A� Y 82317 <br /> 82310 <br /> xl <br /> r^ l 2: 6S \-4 <br /> t M1I'c L t S +J !.RJ <br /> S <br /> t <br /> t <br /> x to -Z? —q 'Z �( Uv/f, 32321 <br /> t i, <br /> 1 f ('6`17-4 �'•s� ilUl�r i 82:312 <br /> , <br /> 4f W— fa- 27- Of 62 o43 <br /> e i qu s e y (Sig lure Tleceived by (Signature) DaterTime <br /> Relinquished by (Signature) Received by (Signal ) Dto/Time <br /> YU V A-� Id asI zic�lfn <br /> Relinquished by (Signat ) Receovbb by Mobile Laboratory for Feld analysis (Signature) date/Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Dale/Time <br /> Method of Shipment r �iLaboratory Name <br /> { GUCIr (/I -r c �4_ C <br /> Special InstructionsVOA! n9ITNOTHER I hereby authorize the perform nce of the above Indicated work <br /> ,�GOOD K V E ` lei✓ , <br /> HEAD SPACE ABSUIT-lef—f CORAINERS <br />
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