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ARCHIVED REPORTS_XR0004948
Environmental Health - Public
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EHD Program Facility Records by Street Name
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M
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MOSSDALE
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444
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3500 - Local Oversight Program
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PR0545585
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ARCHIVED REPORTS_XR0004948
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Entry Properties
Last modified
9/15/2020 11:27:44 PM
Creation date
3/19/2020 3:13:30 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004948
RECORD_ID
PR0545585
PE
3528
FACILITY_ID
FA0000212
FACILITY_NAME
Mossdale Chevron
STREET_NUMBER
444
Direction
W
STREET_NAME
MOSSDALE
STREET_TYPE
RD
City
LATHROP
Zip
95330
CURRENT_STATUS
02
SITE_LOCATION
444 W MOSSDALE RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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i <br /> ( Advanced CHAIN OF CUSTODY RECORd <br /> - GeoEnv�ironmental, Inc. ��$ - e3 Page -� Of <br /> 837 Shaw Road - Stockton, California-95215 -(209) 467-1006- Fax (209) 467-1118 © Q <br /> i 1 <br /> em <br /> ClientN Project Manager <br /> Tests Required <br /> e2idl. L-dJA' <br /> Phone Number <br /> &6q S t16-t -- (00 <br /> Samplers (Signature) Invoice. <br /> Project Name MAGE 9P � Client � <br /> Sample Location Sofld Sample Type No of <br /> Number Description Date Time comp:=0, bWater <br /> Air Conts Notes <br /> fIs to-1 to 4'e x <br /> �l}c� <br /> 01'45 <br /> a <br /> aahm.5jX037 <br /> e l A ece ve y (Signature) oat* 1 e <br /> fn <br /> Relinquish#U by (Signature) Received by (Signature) DatelTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) oate[Time <br /> Dispatched by (Signature) Date/Time Received for Laboralory by Date/Time <br /> a7 s <br /> Method of Shipment Laboralor me <br /> special instructions I hereby thori a the a arm ea of the above indicated work <br /> VAA,r <br />
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