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ARCHIVED REPORTS_XR0012962
Environmental Health - Public
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EHD Program Facility Records by Street Name
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N
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99 (STATE ROUTE 99)
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14800
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3500 - Local Oversight Program
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PR0545626
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ARCHIVED REPORTS_XR0012962
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Entry Properties
Last modified
11/19/2024 1:50:34 PM
Creation date
4/29/2020 2:56:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012962
RECORD_ID
PR0545626
PE
3528
FACILITY_ID
FA0000957
FACILITY_NAME
LATHROP GAS & FOOD MART*
STREET_NUMBER
14800
Direction
S
STREET_NAME
STATE ROUTE 99
STREET_TYPE
RD
City
MANTECA
Zip
95336
APN
19702004
CURRENT_STATUS
02
SITE_LOCATION
14800 S HWY 99 RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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M � W � M M � <br /> s • • <br /> ( Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvi ronmental, Inc. Date Page 1 of <br /> 837 Shaw Road-Stockton California- 95215- (209)467-1006- Fax (209) 467-1118 <br /> 10 J— <br /> Client U� Project Mapager Tests Required <br /> J��My\a, <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> � � AGE aProtect Name � /' � MGL Client E-1Sample Location Date Time Water YPe Solid No of ! Notes <br /> Number Description Comp Grab Air coats <br /> ,- �2 .a p L 1 <br /> Ax— <br /> Pv, CA <br /> ` o � <br /> v 20 S 1 <br /> rt 'r 1 C>oa Ax <br /> e inquis e y ignature) Received by (Signature) DatelTyne <br /> R shed by (Signature Received by (Signature) Date/Time <br /> Rehngmshed by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date(rrme Received for Laborato Date/Time <br /> 7 �61 <br /> Method of Shipment L aratoyyt Na �' <br /> C <br /> Special Instructions I her y authorize the performance of the above indreat work <br />
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