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ARCHIVED REPORTS_XR0010191
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_XR0010191
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Entry Properties
Last modified
5/18/2020 4:04:52 PM
Creation date
5/18/2020 3:46:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010191
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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� �� i i i � i i � Ili i i i ill• til• i� � �� <br /> Advanced CHAIN OF CUSTOD RECORD <br /> _ _ <br /> = GeoEnvironmental, Inc. Date 1i `'� C,3 Pace of T <br /> 837 Shaw Road - Stockton, California-95215-(209)467-1006- Fax(209)467-1118 11- 137 <br /> Project Manager c. <br /> Client X911 r r� c. Tests Required <br /> Phone Number <br /> Samplers (Signature) ��V Invoice <br /> AGE g <br /> Project Namefsce, 6kJ" re_ 1t6(J '-C _z4_��e Client ❑ <br /> Sam <br /> Sample Location Date Time —Water ple Type Solid No of Nates <br /> Number DescriptionAir Cants l <br /> Comp Grab l <br /> t 1 Lc. t L%G <br /> t5&) <br /> -I <br /> e inq s a y (Signature) eceive y ignature DatelTime <br /> Rek ishad by (Signature) Received by (Signature) Datefrime <br /> Retanqutshad by (Signature) Received by Mobile Laboratory for field analysis (signature} DatelTime <br /> Dispatched by (Signature) Date/Time Received for Laboratory bDaterTime <br /> 1 <br /> Method of Shipment La qto am�� <br /> Spectat knatruchona J �, I hereby uthonz9 the performance of the above indicated work <br />
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