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ARCHIVED REPORTS_XR0002523
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_XR0002523
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Entry Properties
Last modified
1/16/2020 6:08:56 PM
Creation date
1/16/2020 4:23:54 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002523
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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CHAIN OF CUSTODY RECORD <br /> =� <br /> Geological Audit Services , Inc . Date ,ru"Q Page <br /> ... <br /> EnYironmenta Professiona/s <br /> Now <br /> Weal Larch Lane Suite A Stockton Cahlornia 9207 (209)95602G4 <br /> r <br /> Client q r�,S 5��► b Project Manager <br /> Vol H40` Tests Required <br /> Phone Number <br /> Samplers (Signature) Invoice, <br /> 1 <br /> Project Name j,.Q"Ylf 06 � GeciAucl t <br /> �h' Client ❑ <br /> Type ype c <br /> Sample Location SampleNo of <br /> Number Descrlption nate Time Wrr Air Solid Conts Q� Notes <br /> Comprab <br /> 95// <br /> 0 <br /> 11.4 W-3 t � -�� -qy Iwo 0093360 <br /> c' <br /> toA <br /> # D� <br /> Relinquished <br /> ysignature) ecawe y (Signature) <br /> r rr Date/Time <br /> Xk--o T&C r SCJ( 9raNciQN[t <br /> Relinquished by (Signature) Recai ed by (Sign re Q Pj sa1' t f�rLtc�r lo DatelTima <br /> idly 9y .-Qo <br /> Relinquished by (Signature) Received by Mobile Laboratory for I analysis (Sr nelurei Date/Time <br /> Dispatched by (Signature) Data/ Flecowad for Laboratory by Date/Time <br /> I <br /> Method of Shipment Laboratory Name <br /> Pa k - <br /> ! Special InstructionsI horeb aut orire the <br /> } y performance of the above Indicated work <br /> I <br /> I <br /> r � <br />
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