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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
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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! ! ! !♦ ! ! ! ! � � � !! �■� !1s fifiiiiiifA �� 1� ws rl�tl■tr <br /> � Advanced <br /> CHAIN OF CUSTOD*ECORD <br /> = GeoEnvlronmental, Inc q �,� Date �- ��fi ' Page of .3 <br /> 4005 North Wilson Way Stockton,California-95205-(209)467-1006-Fax(209)467-1118 <br /> ClientProject Manager <br /> P c r �. t� M %! Tests Required <br /> Phone Number <br /> I-Oa - LJ6 T - tOO6 <br /> g "wt.Samplers (Signature) � � Invoice <br /> �� �� <br /> Protect Name FO r. p Wars �►Uu9 � I'tJ � ,,h" Client ❑ <br /> Sample Type � r <br /> Sample Location Date Time Water Solid No of y� / Notes <br /> Number Description comp Grab Air Conts <br /> -00I, rti X i, <br /> 3t887 <br />� � <br /> K Int/3 "2 h :? C X X X 31888r <br /> Mw3 � y- �,-�a•� - - 31889 <br /> X 31.890 <br /> 31891 <br /> - I �•-��-�� t �� -31892 <br /> 31893 <br /> e,nquis e y ( i nature) Heceived by ignature Dale/Time <br /> Relinquished by (Signature) Received by (Signature) DalelTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Datettime <br /> Dispatched by (Signature) Date/Time Recewed for Laboratory by Date/Time <br /> Method of Shipment Laboratory Name <br /> -� * C fl us a►�; 1 M L (�geth k.L[ I <br /> Special Instructions ^ ':rr 'r' l OA5 I O! IIEiAIS I OTHER I hereby aut{hoorriize�the performance of the above Indicated work <br /> )kUX-1— <br /> IT1QN--Y APPROp,RII,;� <br /> HEAD SPACE ABq"4T— <br />
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