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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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76/ <br /> L� .� � �tm�.n. tiiiiii.� tit_ <br /> CHAIN o <br /> HAIN F CUSTODY*CORD <br /> Advanced <br /> GeoEnvironmental Inc. Date lZ`?1't Page of <br /> 4005 North Wilson Way-Stockton,California 95205-(209)467-1006-Fax(209)467 1118 <br /> ClientProject Manager <br /> L t -�' Cir 2 L�� L� Tuts Required <br /> ,, <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> AGE VProtect Name IL /6-3 a4;4.'i0QYtL Client ❑ <br /> t—� Sample Type <br /> Sample Location Date TimeSolid No of Notes <br /> Number Description Water Air Corals <br /> Comp Grab � <br /> P pry 56708 <br /> I` as 56709 - <br /> Re i vw e y ( i net r Receivedy ignature .} date/Time <br /> W�� <br /> Relinquished by (Signature) Received by (Signature) �fLQ I DatelTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) i �1� n1 In 1i I�IIi <br /> 11 S i <br /> Dispatched by (Signature) Date/Time Received for Laboratory//by tri r , i af'el7ime <br /> 4a or Qi <br /> Method of Shipment fibogtory�Nargii �'���1IVl <br /> 1 1 Y w F sI Y�I k✓Y+flm- i+ <br /> Special Instructions 1 hereby authors Ili pefiotlnancb of the above Indicated work r <br /> is ti.JykW <br /> f <br />
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