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ARCHIVED REPORTS_XR0004950
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_XR0004950
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Entry Properties
Last modified
9/15/2020 11:34:56 PM
Creation date
3/19/2020 3:15:08 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004950
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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Advanced CHAIN OF CUSTOD ECORD <br /> GeoEnvironmental, Inc. ������ Date �;�Yo Page 01 <br /> 637 Shaw Road Stockton, California-95215 - (209)467-1406 Fax (209) 467-1118 <br /> Client J1 top Project Manager Tests Required <br /> Phone umber <br /> 116 7 <br /> Samp s (SI ature Invoice <br /> AG E EJ' <br /> Project Name r K Client ❑ <br /> t�bp5Y <br /> Sample Location Sample Type No of <br /> Number bescnption pate Time Water Arr Solid Conts ` f Notes <br /> Comp Grab <br /> } <br /> Bell q Ish b Received n ate 11 <br /> GOOD COND1TION %=A0A " rsf <br /> TE t <br /> AM RMS <br /> ellnqursh d y (Sign Ye) Received bDE0WUUNg&TEDINLtl��,.P$89, Date(T[ e <br /> ) <br /> Relinquished by (signature) Received by Mobile Laboratory for field analysis (Signature) Date[Time <br /> Dispatched by (Signature) Datef"rime Re give for aborst te/Time <br /> D3 <br /> Method of Shipment La atony a <br /> Ld <br /> Special Inatfucttonr3 1 hereby a)r rize the rfo mance of the above indicated work <br /> i <br />
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