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ARCHIVED REPORTS_XR0003805
Environmental Health - Public
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EHD Program Facility Records by Street Name
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HAZELTON
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375
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2900 - Site Mitigation Program
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PR0540905
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ARCHIVED REPORTS_XR0003805
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Entry Properties
Last modified
2/3/2020 10:08:49 AM
Creation date
2/3/2020 9:19:03 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003805
RECORD_ID
PR0540905
PE
2960
FACILITY_ID
FA0023406
FACILITY_NAME
SIERRA LUMBER MANUFACTURERS
STREET_NUMBER
375
Direction
W
STREET_NAME
HAZELTON
STREET_TYPE
AVE
City
STOCKTON
Zip
95205
APN
147120808
CURRENT_STATUS
01
SITE_LOCATION
375 W HAZELTON AVE
P_LOCATION
01
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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:�.. i tliltititi i f� i♦ � � � <br /> Advanced CHAIN OF USTODY RECORD <br /> GeoEnvironmentai, Inc. Date Page <br /> 637 Shaw Road- Stockton, California- 95215- (209)467-1006- Fax (209)467-1116 <br /> Client <br /> Project Manag01, <br /> Pests Required <br /> P ne Number <br /> 0 crtL <br /> Samp ers Signature) Invoice <br /> Project Name AGE <br /> VO4r Client ❑ <br /> Sample Location Sample Type No of <br /> Number Description <br /> Date Time Water IAir Solid Conts Notes <br /> Comp Grab <br /> F-F <br /> I A <br /> e an e Si atureReceived y tgnature D e/Time <br /> Relrnqursh d by (Signal e) Received by (Signature) <br /> at (rime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date[Time <br /> T�� <br /> r Laboratory by Date/Time <br /> -z 0 � ,�s <br /> Method of ShipmentN—e FLaborato ams <br /> Special Instrucbons i hereby P'o <br /> rize th erformance of the above indicated work <br /> i <br /> dZI <br />
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