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ARCHIVED REPORTS_XR0008308
Environmental Health - Public
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EHD Program Facility Records by Street Name
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S
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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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ARCHIVED REPORTS_XR0008308
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Entry Properties
Last modified
5/20/2020 10:13:32 AM
Creation date
5/20/2020 10:00:12 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008308
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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( Advanced CHAIN OF CUSTODY RECORD <br /> GeciEnvironmental, Inc. I —y Dace 10w-ba Page Of <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 <br /> ClientProject Manager <br /> G L I Trzz' Tests Required <br /> Phone Number <br /> A13 mg� <br /> Samplers (Signature) Invoice <br /> Project Name AGE, <br /> Client ❑ <br /> Sample Location Sample Type .� <br /> Date Time water Sand No of Notes <br /> Number Description Comp crap Air Conts <br /> �x Fri — Q- I��G 51020 <br /> ?u.)4-- r 51021 <br /> I F1 I <br /> Mued y ( ►e) Received by rgnalure Date/Time <br /> Relinquished by (Signature) Received by (Signature) y - Date[Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date(Time <br /> Dispatched by (Signature) Date/TimeReceived for Laboratory by Date/Time <br /> \ � 1 <br /> V <br /> Method of Shipment i i 1 Laboratory Name ff <br /> c�� <br /> Special Instructions r_ i 5 moi, I hereby authorize the performance of the above indicated work <br /> r <br /> � is <br />
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