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ARCHIVED REPORTS_XR0008314
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_XR0008314
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Entry Properties
Last modified
5/20/2020 10:31:04 AM
Creation date
5/20/2020 10:02:08 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008314
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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I 1111111111111111 111111 11- 1111 111111111111111 11111f 1111. lllllllllllll� I_ t_ tl- tf� <br /> � CHAIN O CUSTOD*ECORD <br /> t Advanced �\ 2 <br /> = GeoEnvironmental, Inc Date Page of <br /> i 1 <br /> 4005 North Wilson Way Stockton California 95205 (209)467 1006 Fax(209)467 1118 <br /> Client ProZllk <br /> anager, T Required <br /> ;VCZ466W <br /> Phone Number <br /> 207, XWO <br /> Samplers { ature) Invoice <br /> Project NameEW E1� �L AGE <br /> Client ❑ <br /> Sample Location Date Time Water Sample Type 50110 No of Notes <br /> � <br /> Number Description Camp Grab Air Conts <br /> I <br /> MW-- 17 fd/991W <br /> Ph9 I 01,?l -oq--i <br /> w -Z 1430 -�Z- <br /> w _ 15-5-0 <br /> lots- <br /> w _S IuoO s -- 5 <br /> -tp <br /> w- I <br /> e m is d ( ig lure) Received y (Signature) Dateff e <br /> Relinquishe by Signature) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Dale(Time <br /> Dispatched by (Signature) DalelTime Received for Laboratory by Dateffime <br /> Ab <br /> Method otApipipentkLabotator a <br /> C.4 1 J wto - <br /> Special Inst1 jhereby Authorize <br /> /th/e� performance or the above indicated work <br />
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