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FIELD DOCUMENTS_FILE 2
Environmental Health - Public
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EHD Program Facility Records by Street Name
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SCHOOL
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107
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3500 - Local Oversight Program
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PR0545674
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FIELD DOCUMENTS_FILE 2
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Entry Properties
Last modified
5/20/2020 10:04:05 AM
Creation date
5/20/2020 9:36:33 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
FileName_PostFix
FILE 2
RECORD_ID
PR0545674
PE
3528
FACILITY_ID
FA0006039
FACILITY_NAME
MARK NEWFIELD
STREET_NUMBER
107
Direction
N
STREET_NAME
SCHOOL
STREET_TYPE
ST
City
LODI
Zip
95240
CURRENT_STATUS
02
SITE_LOCATION
107 N SCHOOL ST
P_DISTRICT
004
QC Status
Approved
Scanner
LSauers
Tags
EHD - Public
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e <br /> j Advanced CHAIN OF CUSTODY RECORD <br /> ' GeoEnvironmental, Inc. Date ��' Page _-L—la a <br /> 837 Shaw Road-Stockton,California-95215-(208)467.1006-Fax(209)467-1#18 <br /> ILIm N <br /> CI'lert ` {� P"Martailpr TOM Required � $ <br /> m <br /> Phone Number <br /> Ips} m <br /> Samplers:(Signature) Invoice: <br /> AGE <br /> Project Name I ,� �} �w� u Client 0 <br /> Sample, �5 Location Sample Type No. <br /> of `� <br /> Number Description Date Time Water nir Solid Cords � <br /> Comp. Grab. '{���- ` <br /> Z o �t72�1 <br /> rAw <br /> nn 3 125, v <br /> 7, <br /> x <br /> n <br /> T <br /> tv <br /> m <br /> e <br /> A <br /> Relinquished y: i Flocomd 6V manatur-7— <br /> tyA <br /> alelyi <br /> Relinquished by:(Signatute) Received by:(Signature) Date/Ti o <br /> Relingwshsd by:(Signature) Received by Mobile taborHory lot field eta vee(Signature) C Ddte/rinto ' <br /> Dispatched by:(Signaturo) Dat4fTime, Reeuved or bmuory '' Date/rim <br /> \i <br /> -1 Method of Shipment: story Name <br /> C c c <br /> D A <br /> special Instructions N,^ ^� — 1 herby au lhoNte the performance o1 the above Indicated work. m <br />
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