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ARCHIVED REPORTS_XR0010151
Environmental Health - Public
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EHD Program Facility Records by Street Name
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SHAW
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1500
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3500 - Local Oversight Program
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PR0545688
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ARCHIVED REPORTS_XR0010151
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Entry Properties
Last modified
5/21/2020 4:11:37 PM
Creation date
5/21/2020 10:11:26 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010151
RECORD_ID
PR0545688
PE
3528
FACILITY_ID
FA0003634
FACILITY_NAME
CANTEEN CORPORATION
STREET_NUMBER
1500
Direction
N
STREET_NAME
SHAW
STREET_TYPE
RD
City
STOCKTON
Zip
95205
APN
14326008
CURRENT_STATUS
02
SITE_LOCATION
1500 N SHAW RD
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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� � !� f� � ti � � t� �t � ■� Iwtr t�wi� t�wr �� w.. <br /> � *Advanced <br /> CHAIN OF CUSTODY&CORD <br /> w <br /> - GeoEnvironmental, Inc. sate Z Page of <br /> 837 Shaw Road - Stockton, California-95215 - (209) 467-1006 - Fax (209) 467-1118 1 <br /> Client r -ro !L P affect Manager 1 Tests Required <br /> 2u VIF" �P_ � ?tZ_w �, Phone Number <br /> l �� r�'`IS �Z ' Samplers (Signature) invoice <br /> 'I,— ` _ � AGE EJ <br /> Pro)ect Name ,tzq&4-YC 7 / 7 L, ,—� Client, <br /> Sample Location Solid No of Notes <br /> Number Description Date Time Sample Type Water Air Conts <br /> Comp (arab <br /> �- <br /> 2-6 -- 2-0 ` ,?' d2- s' ?� <br /> l t,� <br /> i <br /> F <br /> e, is 1 iii _ <br /> �fGSi1 S1 A i}1U <br /> He qui ed y { 1 Received y ignalure OatelTime <br /> - 27 0 -2- 1 ' <br /> Rei+nquis ed by {Signature) Received by (Signature) e Q e/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatelT+me <br /> Dispatched by (Signature) Date/Time Received for Laboratory by r Date/T me <br /> Method of Shipment % Laboratory Name <br /> �r]neciai Instructions y { I her thorize the ffmanc of the above indicated work <br />
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