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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
Tags
EHD - Public
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� I• � i• � � � I• l• � � � � � � its <br /> (� Advanced <br /> CHAIN OF CUSTODOECORD <br /> I� r O� 4 3 of -3 <br /> GeoEnv><ronmental, Inc. Date Page 1 � y" ^ � <br /> 4005 North Wilson Way-Stockton,Cafifomla-95205-(209)467-1006-Fax(209)467-1118 <br /> Client P-, 1-4 Project Manager Tests Required <br /> � t'A?Vi K ':14,04 4(4 P) <br /> Phone Number <br /> ?-04 I L46 1% 1006 <br /> Samplers (Signature) Invoice <br /> Pro ect NameAGE <br /> tiL ry r �� <br /> t I' W'a V c k d U y i; �'`i�'"'" /� �h� Client ❑ <br /> Sample LocationSample Type Date Time Solid No of Notes <br /> Number Description Water Air Conts <br /> Comp Grab31894 <br /> + <br /> a <br /> -115' X 31895 <br /> Relinquish ed by (Signfitute) eceive (Sig <br /> nature batefT me <br /> s dar �•�.T, �s. �oo I <3C1 <br /> Relinquished by (Signature) Received by (Signature) DateJTlme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Date(Time <br /> Method of Shipment Laboratory Name <br /> G,A v U �r� PI VDAS I O&G I MRALS1 OTHER' H '-(A W0 I-f Q <br /> Special Instructions 1c I hereby authorize the performance of the above Indicated work <br /> I <br /> HEAD SPACE ABSENT CG1%"'A1N',-I S_�. <br />
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