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ARCHIVED REPORTS_XR0002198
Environmental Health - Public
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EHD Program Facility Records by Street Name
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G
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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_XR0002198
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Entry Properties
Last modified
1/28/2020 8:59:32 AM
Creation date
1/28/2020 8:29:37 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002198
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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� r ' t� i� i• � � � � i• � � � � � t� <br /> 1 vanced CHAIN OF CUSTOD CORD <br /> GeoEnvironmental, Inc. Date /3 t,'&-Page at <br /> of Norlhem Cahfomma <br /> 1803 West March Lane,Suite A Stockton, California-95207-(209)956-0264-Fax(209)956-0700 A/V26 �? <br /> Client Project Manager <br /> Tests Required <br /> Phone Number <br /> A y <br /> Samplers (Signature) invoice <br /> Project Name k AGE k <br /> Client ❑ <br /> Sample Location Sample Type <br /> Date Time Water Air Solid ants Notes <br /> Number Description _ _ __ __ _ 1 <br /> Comp Grab <br /> 54425 <br /> f <br /> 54426 <br /> 5442 <br /> �f 54428 ' <br /> Ulrtu�— / .2-1 3! '� //' �a 7j �' t� i i <br /> t <br /> r <br /> He{nqurs a y (Signature y jgnat Date/Time <br /> Relinquished by (Signature) ved by (Slgnaturp) —< <br /> Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for held analysis (Signature) DalelTime <br /> Dispatched by (Signature) Date/Time Received for Laboratory by <br /> �.L Dale/Time <br /> �+ethod of Shipment laboratory Name <br /> d Ok---9�14L�Fee-nvv',�- -6do,4c-Qnl� <br /> Special Instructions V <br /> T� I hereby authorize the perlormance of the above Indicated work <br /> 1 � <br /> HEAD SPACE ABSENUE <br /> r� <br />
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