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ARCHIVED REPORTS_XR0010161
Environmental Health - Public
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EHD Program Facility Records by Street Name
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S
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SHAW
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1648
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3500 - Local Oversight Program
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PR0545689
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ARCHIVED REPORTS_XR0010161
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Entry Properties
Last modified
5/18/2020 4:05:20 PM
Creation date
5/18/2020 3:27:28 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010161
RECORD_ID
PR0545689
PE
3528
FACILITY_ID
FA0005164
FACILITY_NAME
FISCO WAREHOUSE
STREET_NUMBER
1648
STREET_NAME
SHAW
STREET_TYPE
RD
City
STOCKTON
Zip
00000
CURRENT_STATUS
02
SITE_LOCATION
1648 SHAW RD
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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a■t1■ tf� f� ti f� � tits A i� 1� � t1� � � � <br /> Advanced • CHAIN OF CUSTODAECORD <br /> � cad <br /> - GeciEnvironmental, Inc. ILI 1057AGM-71 ��(�, ,��� Date '00 (sage —L of 3 <br /> 4005 North Wilson Way-Stockton,California-95205 (209)467-1006 Fax(209)467-1118 <br /> Client 1. e L Project Manager Tests Required <br /> Ke V h M C K <br /> Phone Number <br /> )X4 - 46.1 - t00 � <br /> Samplers (Signature Invoice <br /> Project NameF t 5 C W�Ux X10(� �� AGE (g <br /> K Client ❑ <br /> Sample Type ` <br /> Sample Location Date Time Water Solid No of � / Notes <br /> Number DescriptionWater <br /> Grab Air Conts <br /> 31880 <br /> m W i - 3,i- <br /> 14W <br /> 514W 1 1oe" fG X1 X ', 31882 <br /> Mw •0I " 1y __ 31883 <br /> 9:0 y X 1 X- X ; _ 31884 <br /> Mw 2- -35- 11191 X K ', 3.1885 <br /> $ 1886 <br /> e nqu`s e y (Signature)T ace ve yignature) 2 Dale/Time <br /> 444� <br /> Relinquished by (Signature) Received by (Signature) V Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Despatched by (Signature) DalelTlme Received for Laboratory by Date/Tims <br /> Method of Shipment S Laboratory Name <br /> VU <br /> Speck Instructions syn cf `I 7`n�` I hereby authorize the performance of the above Indicated work <br /> Ic '/ <br /> fi1JCYA{iUIV <br /> GOOD CONDITION—=- APPROPHIME <br /> r• <br /> HEA , _r �.•�'1 <br />
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