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ARCHIVED REPORTS_XR0012252
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_XR0012252
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Entry Properties
Last modified
10/10/2020 11:16:52 PM
Creation date
3/17/2020 1:50:07 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012252
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
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EHD - Public
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rr r� �r r r rr rr �r ■r ■r r rr rr rr r rr i r r <br /> CUSTODY *CORDCHAIN OF , <br /> Advanced Date P-46-03 Page ori <br /> GeoEnvironmental, Inc <br /> 837 Shaw Road Stockton, California-952115 - (209) 467-1006 - Fax(209)467-1118 ( 0 - 1 <br /> [� } <br /> , Project Manager Tests Required <br /> Client Lc � � & // L./ /-P— <br /> Phone Number <br /> V(o ? <br /> Sam lers (Signature) Invoice <br /> i <br /> AGE JE�— <br /> Pro)ect Name � / ,1 �5 /'1� � � Client ❑ <br /> Sample Type No of �l `� N Notes <br /> Sample: Location Date Time Water Air Solid �a <br /> Number Description Cotes <br /> Comp Grah <br /> �►w r a r v N•GJ f 116 J zZa / J <br /> A-AiiJ3 la/46 as L'i 3 r t /25 <br /> rt 141!'4 <br /> ImI5 <br /> LlqnalurO <br /> 5 <br /> Date/Time <br /> eceiy (a4 1(0AD <br /> / Daterrime <br /> Relinquished by ( g <br /> Received by (Signature) <br /> Date[T+me <br /> Relinquished by (Signature) Recewed by AAobile Laboratory for field analysis (Signature) <br /> D ite/Time Received for Laborator Dale/Ti <br /> Dispatched by (S+gnature} d_ }f] 043 <br /> La ratory me <br /> �Melhod o} Shipment n /(/JR+C� 1 hereb authorize the performance of the above indicated work <br /> pecial Instructions <br />
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