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SITE HISTORY_CASE 1
Environmental Health - Public
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EHD Program Facility Records by Street Name
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L
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LOUISE
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2901
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3500 - Local Oversight Program
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PR0545440
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SITE HISTORY_CASE 1
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Last modified
3/9/2020 4:57:20 PM
Creation date
3/9/2020 2:20:38 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE HISTORY
FileName_PostFix
CASE 1
RECORD_ID
PR0545440
PE
3528
FACILITY_ID
FA0003845
FACILITY_NAME
MUSD-DISTRICT OFFICE
STREET_NUMBER
2901
Direction
E
STREET_NAME
LOUISE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
APN
19811004
CURRENT_STATUS
02
SITE_LOCATION
2901 E LOUISE AVE
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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Lab Report # <br /> .. <br /> . GeoAnalytical Laboratories, Inc, p <br /> 1405 Kansas Avenue Phone(209)572-0900 <br /> Modesto,CA 95351 FAX(209)572-0916 <br /> Phone: <br /> Client: : Ca _...__._ CHAIN OF CUSTODY Fax: - 0-5 � <br /> Address: To: <br /> 6 fl Zip 5� <br /> Project ID N14u1 ffr+JEAJ sc/tOdG <br /> (Print Name) �� t <br /> F y Z U <br /> Sampled Q (Signature) �� r <br /> All) <br /> Container o <br /> U -� V Lab ID# <br /> SampEe type mo �a <br /> Date Time Saple ID Sire is <br /> Z <br /> Grab Comp Matrix <br /> 'Z— <br /> ;7 ' <br /> L <br /> ; ; ; <br /> Remarks <br /> 54 f1i 6) <br /> Relinquished by (Signature) Date 'time Received by (Signature) Date 'Time. <br /> Relinquished by (Signature) Date Time Received by (Signature) Date Time <br /> Relinquished by (Signature) Date Time Received At Laboratory by(Signature) Date Time <br /> Site Time: W '] Driving Time: Total Hours <br /> Start: (} Finish: Total Hours: 7 Start: Site Arrival: x2= <br /> Mileage Approved By 14- (4 rar-i <br />
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