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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
Scanner
SJGOV\sballwahn
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EHD - Public
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Advanced GeolEnvironmental, Inc. www.advaeoenv.colD CHAIN OF CUSTODY RECORD <br /> 837 Shaw Road,Stockton,California 95215 • Phone(209)467-1006 • Fax(209)467-1118 � 'a Date:—1-3 r3 -CV Page of G— <br /> i. .., 381 Thor Place,Brea,California 92821 • Phone(714)529-0200•Fax(714)529-0203 <br /> ❑ 2318 Fourth Street,Santa Rosa,California 95404 • Phone(707)570-1418 •Fax(707)570-1461 Analysis Required <br /> ❑ 395 Del Monte Center,#1 l 1,Monterey,California 93940 • Phone(800)511-9300 •Fax(83 1)394-5979 <br /> ❑ `7 <br /> Pr 'ec[Name Project Manager •,L <br /> i <br /> Client Sampler(initials&sign <br /> Invoice to: AGE ❑ Client Lab Project No.: I <br /> t1 <br /> Sample ID/Location/Description ,+Date Time Matrix Number Notes y <br /> R inquished by: Date: ()'110 Time: Labo ry: <br /> Ch <br /> Courier: I Received by: Date: Time: <br /> On TV42 <br /> Relinquished by: Date: Time: Received by: Date: Time: <br /> Relinquished bv: Date: Time: Received by: j���^�7 Date: J Time: <br /> Requested Turn Around Time(circle): 24 hours 48 hours 72 hour ys(standard) Other: Matrix Codes: A=Air w=water S=Solid <br /> Special Instructions to lab: I hereby authorize the performance of [ ove indicated work. <br /> Global ID: <br /> Geo[racker EDF to: geotracker@advgeoenv.com ❑ <br />
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