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ARCHIVED REPORTS_XR0005230
Environmental Health - Public
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EHD Program Facility Records by Street Name
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M
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4040
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2900 - Site Mitigation Program
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PR0545496
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ARCHIVED REPORTS_XR0005230
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Entry Properties
Last modified
9/24/2020 12:37:35 AM
Creation date
3/10/2020 8:44:45 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005230
RECORD_ID
PR0545496
PE
2957
FACILITY_ID
FA0003564
FACILITY_NAME
BLUE STAR
STREET_NUMBER
4040
Direction
E
STREET_NAME
MAIN
STREET_TYPE
ST
City
STOCKTON
Zip
95205
APN
15727503
CURRENT_STATUS
02
SITE_LOCATION
4040 E MAIN ST
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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rr r r r rr r rr r r rr rr rr r r rr r rr rr r <br /> ( Advanced a �; s� <br /> CHAIN OF CUSTOISECORD <br /> - ot <br /> GeoEnvironmental Inc. Date 9Paye <br /> 837 Shaw Road- Stockton,California-95215-(209)487-1008-Fax (209)487-1118 <br /> Client G Pioli M, <br /> L er kvtat,M Tests Required <br /> Phone Nuber <br /> (�09 7 <br /> Samplers {S at Invoice <br /> f / AGE <br /> Protect Nam s CAr Gid <br /> Sample Location <br /> Sample Type � <br /> Solid No of Notes <br /> Date TimeWater <br /> Nu ber Description comp Grab Air Corns <br /> i i"� 5CIA ' <br /> • G <br /> e i ui e y tgna a ecerve y rgne�ure <br /> ate <br /> te <br /> Relinqutshed by (Signature) Received by (Signature) DatelTime <br /> Relinquished by (Signature) Received by Mobile laboratory for field analysis (Signature) Date(Time <br /> Dispatched by (Signature) Date/Time Recewe to t rato to/Tim" <br /> 0Sr— DC <br /> Method of Shipment Labor Name <br /> V v 2LD , <br /> Special insttucUans NNA A 1 hereby authorize the part rmance of i above indicated work <br />
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