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ARCHIVED REPORTS_XR0012249
Environmental Health - Public
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EHD Program Facility Records by Street Name
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M
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MINER
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3500 - Local Oversight Program
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PR0545551
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ARCHIVED REPORTS_XR0012249
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Entry Properties
Last modified
10/10/2020 11:20:39 PM
Creation date
3/17/2020 1:48:57 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012249
RECORD_ID
PR0545551
PE
3528
FACILITY_ID
FA0012578
FACILITY_NAME
CHETS AUTO
STREET_NUMBER
545
Direction
E
STREET_NAME
MINER
STREET_TYPE
AVE
City
STOCKTON
Zip
95220
CURRENT_STATUS
02
SITE_LOCATION
545 E MINER AVE
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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• CHAIN OF CUSTODRECORD <br /> Advanced tZ�' Jpa l <br /> GeciEnvironmental, Inc °Datese °� <br /> 837 Shaw Road Stockton, California- 95215- (209)467 1006- Fax (209) 467-1118 3 ^ '0 o5 <br /> Client l Vy\ �cc,YV), � Project Manager <br /> ���t� Tests Required <br /> phoneumber <br /> C-T <br /> �--(�- Le <br /> Samplers ( nature) �Z> Invoice <br /> Project Name �j� I �' a Client ❑ <br /> Sample Location Date Time Wamer Type Solid No of / Notes <br /> Number DescriptionCompcrab Air Conts <br /> UW <br /> jJ A l3 <br /> e aqui e y nalur ecerve y ignature DatefT e <br /> ��Gr 3G <br /> wished by (Signature) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysts (Signature) Datefrime <br /> Dispatched by (Signature) Date[Time Received for Laboratory by Datealme <br /> ^�t -1 01 <br /> Method of Shipment Leb tory Name <br /> Special Instructions I her lh nze the p rmanc of the above Indicated work <br />
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