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ARCHIVED REPORTS_XR0010240
Environmental Health - Public
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EHD Program Facility Records by Street Name
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S
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SEVENTH
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15615
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3500 - Local Oversight Program
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PR0545683
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ARCHIVED REPORTS_XR0010240
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Entry Properties
Last modified
5/20/2020 4:04:46 PM
Creation date
5/20/2020 3:56:28 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010240
RECORD_ID
PR0545683
PE
3528
FACILITY_ID
FA0005408
FACILITY_NAME
LANGSTON ARCO*
STREET_NUMBER
15615
Direction
E
STREET_NAME
SEVENTH
STREET_TYPE
ST
City
LATHROP
Zip
95330
CURRENT_STATUS
02
SITE_LOCATION
15615 E SEVENTH ST
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
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LSauers
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EHD - Public
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r ` ar r r r r r r r r r r r r r r r r r <br /> Advanced CHAIN OF CUSTOL RECORD <br /> GeciEnvironmental, Inc. Date S 3 Page of <br /> 837 Shaw Road - Stockton, California- 95215 - (209) 467-1006 - Fax (209) 467-1118 <br /> Client"^ P ' ct Mag <br /> Tests Required <br /> P one Number <br /> mp ers: (Signature) Invoice: <br /> Project Name AGE <br /> 7VL �� - 4. Client ❑ <br /> Sample L cation Date Time — Sample Type No. of <br /> Number Description Water Solid Notes <br /> Camp. Grab. Air Conts. <br /> �. L <br /> ( 215-7 <br /> �e i 5 y: E nature) ece ve y: ignature <br /> atelTlme -,l <br /> Relin uished y: (SIqnatureT Received by: (Signature) Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) Datemme B66 iv+d r Lpborator <br /> � Date/Time <br /> 7 <br /> Method of Shipment: " Labor ato y NA <br /> _ f <br /> SpeCia�wclions:� <br /> ' } I hereby aul a the p larmance of the above liadicated work. <br />
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