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FIELD DOCUMENTS
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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PR0541800
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Last modified
3/16/2020 4:49:55 PM
Creation date
3/16/2020 2:00:11 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0541800
PE
2960
FACILITY_ID
FA0023969
FACILITY_NAME
CANCUN RESTAURANT
STREET_NUMBER
135
Direction
E
STREET_NAME
MINER
STREET_TYPE
AVE
City
STOCKTON
Zip
95205
APN
13908010
CURRENT_STATUS
01
SITE_LOCATION
135 E MINER AVE
P_LOCATION
01
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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Advanced GeoEnvironmental, Inc. www.adveeoenv.com CHAIN OF CUSTODY RECORD <br /> ,837 Shaw Road,Stockton,California 95215 • Phone(209)467-1006 • Fax(209)467-1118Date: 9—•7`Lam. Page I oPl <br /> ii .. <br /> F--1381 Thor Place, Brea,California 92821 • Phone(714)529-0200• Fax(714)529-0203 Q<PO ?J//_ <br /> ❑ 2318 Fourth Street,Santa Rosa,California 95404 • Phone(707)570-1418 • Fax(707)570-1461 Analysis Required <br /> ❑ 395 Del Monte Center,?#I 11,Monterey,California 93940 • Phone(800)511-9300 • Fax(831)394-5979 <br /> ❑ I <br /> Project Name Project Manager <br /> 1 J ' YL'1 UI 1 - L1I . <br /> Client Sampler(initials&signature) J <br /> AU/-n i J <br /> AUY T <br /> Lab Project No.: tA� <br /> Invoice to: AGE 11 Client <br /> Sample ID/Location/Description Date Time Matrix Number Notes -- <br /> w 4f9_I - 6q[5 <br /> cl 231 <br /> i k <br /> X <br /> a45 09� -Io 6qy f I l� <br /> Relinquished by: Date: Time: Laboratory: <br /> CC?_� <br /> �(p Received by: Date: Time: <br /> Courier: <br /> Relinquished by: Date: Time: Received by: Date: Time: <br /> Relinquished by: Date: Time: rRv—ce,,edby: n / Date: Time: <br /> Ofd JI�74-'u� til,a.,-- <br /> Requested Turn Around Time(circle): 24 horns 48 hours 72 ho'C' ays dard) Othen Matrix Codes: A=Air W=Water S=Solid <br /> Special Instructions to lab: I hereby authorize the performance of the above indicated work. <br /> Global ID: L/�� ' A4L' <br /> Geotracker EDF to: 0 geotracker@,advgeoenv.com ❑ <br />
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