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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.advgeoenv.com CHAIN OF CUSTODY RECORD <br /> 837 Shaw Road,Stockton,California 95215 • Phone(209)467-1006 • Fax(209)467-1118 Date: 1—7-..3C1-l0 Page_L of — <br /> 2 <br /> o c <br /> i�.. 381 Thor Place,Brea,California 92821 • Phone(714)529-0200* Fax(714)529-0203 C _ <br /> ❑ 2318 Fourth Street,Santa Rosa,California 95404 • Phone(707)570-1418 • Fax(707)570-1461 Analysis Required <br /> ❑ 395 Del Monte Center,#111,Monterey,California 93940 • Phone(800)511-9300 • Fax(831)394-5979 <br /> ❑ I 7 <br /> Project Name Pro <br /> inager i t <br /> ' I'1 <br /> Client Sampler(initials&sign lure) <br /> Invoice to: AGE El Client Lab Project No.: <br /> t- �y <br /> Sample ID/Location/Description Date Time Matrix Number Votes <br /> =2`"U 02:2,5 A)l <br /> . :Z0 ,2-7,16 10931 hW, <br /> -td - x 'x x <br /> 7.1610 <br /> � _ r x <br /> %536 AO 77,ITA 40111 S I Al) <br /> 2(3vo S Ix IX, kX <br /> We M? /t®® <br /> uis ed by: Date::q Time: La oratory: <br /> Courier: Received by: Date: Time: <br /> `/'�' <br /> Relinquished by: Date: Time: Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: ^ Date: Time: <br /> Requested Turn Around Time(circle): 24 hours 48 hours 72hours��days standard) Other: �� Matrix Codes: A=Air W=Water S=Solid <br /> Special Instructions to lab: 1 hereby authorize the performance of ttbc a/7boove iof^d-iicccattteedd work. <br /> Global 1D: <br /> Geotracker EDF to: geotracker(aadvgeoenv.com ❑ <br />
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