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ARCHIVED REPORTS_XR0010175
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_XR0010175
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Entry Properties
Last modified
5/18/2020 4:06:43 PM
Creation date
5/18/2020 3:42:33 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010175
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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Advanced CHAIN OF CUSTO RECORD <br /> - GeoEnvironmental, Inc. Date Page ---L of <br /> 837 Shaw Road-Stockton, California- 95215-(209)467-1006 - Fax(209)467-1118 rn q <br /> ClientProject Manager <br /> L Tests Required <br /> Pone N m r <br /> Samplers: (Signature) Invoice: <br /> Project Name <br /> ACE �- <br /> \,Jare 1 - ¢, U Client ❑ <br /> ] <br /> Sample Location Sample Type <br /> Date Time Water Solid No. of •'�r ti Notes <br /> Number Description comp. (arab. Air Solid <br /> Z L-$tpCq <br /> ftoo a [so,/ <br /> JID20 I K I X <br /> .w 7 I Pb �w '7 1 11120 <br /> V-0 3,1.p!�,q <br /> Relinquished y; igna re) ece ve y: ignature (1 te/Tim <br /> Relinquished by: (Signature) Received by: (Signature) Date/ me <br /> Relinquished by: (signature) Received by Mobile Laboratory for field analyais:(Signature) Date/Time <br /> I)ispatchad by: (Signature) Date/Time Receivod for Labo tory.by. Date[Time <br /> Method of Shipment; Laboratory Name <br /> i <br /> cc,� Cj►��'{� l C�. C <br /> special Instructions: I hereby authorize the performance of a abo 1ndlcated work. <br />
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