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ARCHIVED REPORTS_XR0010220
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_XR0010220
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Entry Properties
Last modified
5/18/2020 4:12:06 PM
Creation date
5/18/2020 3:52:53 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010220
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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i i i � � � � f• � � � 1♦ I� � � � � � � <br /> � Advanced <br /> CHAIN OF CUSTOD4CORD <br /> GeoEnyironmental, Inc. Date 41al 0)- Page _L of <br /> c', <br /> 4005 North Wiison Way-Stockton,California-95205 (209}467-1006-Fax(2f9):::46711 <br /> ClientProject Manager 11 <br /> a, �f n oAJ► ^assts Required <br /> Phone Number <br /> e <br /> Samplers: (Signature) Invoice: <br /> Project Name AGE <br /> IS c_.G L}�7�ko li6v ! Client <br /> Sample 7 pe <br /> Sample Location Date Time Water Solid No- of Notes <br /> Number Description Camp. Grab. Air cants. <br /> —LM- _ _ I Ic o j a — + 88129 <br /> -Y(:) L� -- - - - i 88130 <br /> +. 88131 - <br /> elinquis a y: ignature eeccei}ve[ y: Sj ngtu()rskl � - ) i]atefTlma <br /> Ralinqul Ked by: ( ignature) Received by: (Signature) Date/Time <br /> Relinquished by: (Signature) Received by Moblle Labotalory for field analysls: (Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: Date/Tlme <br /> Method of Shlpm nl: „ ,n Laboratory Name <br /> S acial 0000 <br /> CVC Tn R_-_ r 1P "0PR! TE i hereby autlroriza the perfor the above Indianlad work. <br /> - tin���ri= QLWT r�,�; 9�N� ------- <br />
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