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ARCHIVED REPORTS_XR0002158
Environmental Health - Public
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EHD Program Facility Records by Street Name
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GRANT LINE
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2420
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3500 - Local Oversight Program
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PR0545209
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ARCHIVED REPORTS_XR0002158
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Entry Properties
Last modified
1/28/2020 8:59:26 AM
Creation date
1/28/2020 8:22:10 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002158
RECORD_ID
PR0545209
PE
3528
FACILITY_ID
FA0003963
FACILITY_NAME
TRACY76
STREET_NUMBER
2420
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
Tracy
Zip
95377
APN
23802006
CURRENT_STATUS
02
SITE_LOCATION
2420 W GRANT LINE RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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( Advanced CHAIN OF CUSTODY RECORD <br /> c —�y-0z <br /> GeoEnvironmental, Inc. Date Page Zt Of - <br /> 837 Shaw Road- Stockton, California 95215- (209) 467-1006 - Fax(209)467-1118 <br /> Client " T' S�r e Project Ma age t � I Tests Required <br /> 4 n <br /> Phone Dumber <br /> -201-- N67— lOGG <br /> Samplers (Signature) �Q'� �t. y Invoice. <br /> Project Name ff�1 0 ACP Jg- <br /> Client ED <br /> k � <br /> 5ampla Location Sape <br /> Date Time No of <br /> Number Description Comp Grab Water Air Solid Conts �� Notes <br /> A. <br /> 0 2— <br /> I <br /> el q ( ignat re) ecerve y gnature ' Datefrtme <br /> vis OCG gars 4 /L:oo <br /> ws Si nature Received b PRESERVATION <br /> Y 9 ) y (Signature) DatelTime <br /> HEAD CQNDITION -=--COP�RTOF�- <br /> HEAf3SPACE <br /> Relinquished by (Signature) Received by Mobile Laboratory for field a i�1$.__PUMV$DIN1.AA Date(Time <br /> I r, <br /> Dispatched by (Signature) Date/Ttme Re ei IoCLaborato by Daterrime <br /> 'lam V G 12q I o , (DU <br /> Method of Shipment h aboratory Name ��r <br /> Special instructions I hereby authorize the performance of the above indicated work i <br /> I <br />
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