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ARCHIVED REPORTS_XR0005231
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0545496
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ARCHIVED REPORTS_XR0005231
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Entry Properties
Last modified
3/10/2020 9:06:16 AM
Creation date
3/10/2020 8:45:18 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005231
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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i ! <br /> CHAIN OF CUSTODIRECORD <br /> Advanced <br /> -== GeoEnvfronmental, Inc. Date Page --Cc-- of <br /> 837 Shaw Road - Stockton,California-95215 - (209)467-1006- Fax (209)467-1118 <br /> Project Manager <br /> Client ���{� f Tests Required <br /> Phone Number <br /> Sampl Sign ur ` Invoice <br /> AGS <br /> Project Name <br /> 1 Q� � �._ Client El <br /> Sample Type � <br /> Sample Location Date Time Water Solid No of , � ' f Notes <br /> Number Description Comp Grab Air Conts9' <br /> Irviuv 3�`Za 1{ Zo` ft2o <br /> d�Gw3�3a fC 30 l 3 S <br /> AW3-;S rr �Sr� ll`�� NX Y- )i( <br /> vW,�n13 to o` t150 <br /> MN-3-'t5-- J tC g5-1 >> ss- 2( ?C <br /> e in ed by ignat ) ecerva y (Signature) Dater a <br /> �nquished by�(Si ure) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Reoelved by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Re cai ed r abora ry by atelTime <br /> Method of Shipment II j Laboratory Name f <br /> Special Instructions I hereby authorize the performance of the above indicated work <br />
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