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FIELD DOCUMENTS_CASE 2
Environmental Health - Public
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EHD Program Facility Records by Street Name
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M
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MARIPOSA
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13521
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3500 - Local Oversight Program
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PR0545534
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FIELD DOCUMENTS_CASE 2
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Last modified
3/13/2020 1:49:23 AM
Creation date
3/12/2020 11:59:56 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
FileName_PostFix
CASE 2
RECORD_ID
PR0545534
PE
3528
FACILITY_ID
FA0001457
FACILITY_NAME
COLLEGEVILLE MARKET & CAFE
STREET_NUMBER
13521
Direction
E
STREET_NAME
MARIPOSA
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
18306007
CURRENT_STATUS
02
SITE_LOCATION
13521 E MARIPOSA RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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[ [ C [ [ [ [ [ I C [ [ [ [ t t [ t [ <br /> Condor Earth Technologies, Inc. <br /> CHAIN—OF-CUSTODY ❑ 21663 Brian Lane 188 Frank West Circle, Suite I <br /> N 0— 4770 P.O. Box 3905 /Sonora,California 95370 Stockton, CA 95206 <br /> 209-532-0361 209-234-0518 <br /> 209-532-0773 (fax) 09-234-0538 (fax <br /> info@condorearth.com(e-mail) con or condorstockton.com(e-mail) <br /> SHIPPED TO: 41-1110,5 <br /> SENLRRESULTS TO: <br /> ArAe C;i c << .� 1 NAME: pA16 MOD ��/-; Y&JA16 <br /> 7 i <br /> OFFICE: 5T04oe-77,1141 <br /> � ] PLEASE FAX RESULTS: -dry. PROJECT: 3652 6/&eviAe 15" 1 <br /> PROJECT NO. L NO Sties' ✓ Verification <br /> cl y�` l <br /> SAMPLED Bof <br /> , con- <br /> (Signature) tain- �/��' <br /> Date Time S ple ID ers �• REMARKS: MISC. <br /> 5-7—= 1019 <br /> 5 7L <br /> /05,7 YRim <br /> k <br /> Relinquished By: d D4 e: Time: Received By: Datf: Time: <br /> (Signature /, G Z4(' '�% �� (Signature) S U �'C <br /> Relinquished By: Date: Time: Received By: Date: Time: <br /> (Signature) (Signature) <br /> Relinquished By: Date: Time: Received By: Date: Time: <br /> (Signature) (Signature) <br /> Original-Send Yellow-File Pink-Log Book <br />
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