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ARCHIVED REPORTS_XR0002525
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_XR0002525
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Entry Properties
Last modified
1/16/2020 5:43:54 PM
Creation date
1/16/2020 4:25:53 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002525
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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' � � � � � � j� � � w■ i• w awr tip <br /> CHAIN OF CUSTOD RECORD <br /> -� Geological Audit Services , Inc . , owe ` page of <br /> — =;V En�rrx7mef�ta Pmfessnoir7afs <br /> 1803 West March Lane Suite A-Stockton California-95207-(2091 956-0264 <br /> Client h�r� es �Co�+?i��G Project Manager Tests Required <br /> Gc'� moms -CJr�ue,ri <br /> 72o l3 Cl DOY-cz8o S,ivee, Phbne Number <br /> C oC0e)G-6-0a,1,q <br /> Samplers (Signature) Invoice <br /> ' GeaAudlt [gProject Name LorYkjS �Ao ��wc.��v✓ Ge,A a"Y�;lrv�"�w�/lin, � Q, Client ❑ <br /> i <br /> Sample Location Date Time Sample Type Solid No of �� Notes <br /> Number Description <br /> Comp Air Conts e <br /> En?--i Z- z--91 <br /> Z 1.32 <br /> Relinquished y ignatureReceived (Signature Date/Time <br /> *'t' N0rw.a9 Tei 2-��-Yy � • ' <br /> Relinquished by (Signature) Received by (Sig Lure) Date/Time y <br /> �� tiYiS�,L�s 1O �7oc�gSl�- 070 <br /> Relinquished by (Signature) Received by Mobile Laboratory for held analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Datefrime <br /> Method of Shipment Laboratory Name <br /> Special Instructions I hereby authorize the performano* of the above Indicated work <br /> t' vWw <br />
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