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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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CHAIN OF CUSTODOECORD <br /> Advanced Date (`� jar Page t of <br /> --- GeoEnvironmental, Inc. / <br /> 837 Shaw Road Stockton, California- 95215 - (209)467-1006- Fax (209)467-1118 (/-> `[ 3 <br /> Client C( YA Project Manager Tuts Required <br /> I <br /> O <br />� <br /> one Number —7 � <br /> (dC)(�4 <br /> Sam lers (SI e 0 Invoice <br /> AGE <br /> Project Name � S Client ❑ <br /> Sample Type <br /> Sample Location Date Time Water Solid No of N Notes <br /> Number DescriptionnComp crab Ar Corns <br /> kWL_ <br /> o <br /> =Refi—Equishr <br /> r atu e} nerve y rgnature Date/Tred by ( ignature) Received by (Signature) DatelTime <br /> S .ie—ceivedby <br /> Rehngwshed by (Signature) Mobile for e Laboratory held anaiyai (Signature) I Date/Trme <br /> Date/Time R�Irry y alelTims �� <br /> Dispalched by (Signature) 1J vey— <br /> hLaboratory Name <br /> Method of Shipment h Ct <br /> I her authorize erformance o he above Endreated work <br /> Special instructions 4� <br />
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