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ARCHIVED REPORTS_XR0010300
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_XR0010300
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Entry Properties
Last modified
5/21/2020 3:15:54 PM
Creation date
5/21/2020 10:19:27 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010300
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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LSauers
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EHD - Public
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MEbECORD <br /> dvanced CHAIN OF CUSTODY <br /> GeoEnvironmental Inc, q Date*;L&LPage -i- Of <br /> 4005 Notth Wilson Way-Stockton,Caiifomia-95205 (209)467 1006-Fax(209)467-1118 <br /> Client uB k Fat, CA jE Prole a ager Tests Required <br /> )qa& - <br /> P ne umber <br /> .7 <br /> (Si nater ) Invoice, <br /> AGE !/S <br /> Protect Name � { 0 Client ❑ <br /> • Sample Type <br /> Sample Location Date Time Water Solid No of ` Notes <br /> Number Description comp arab Air Conts <br /> 61886 <br /> ]] 3 1 _ 6_a 890 <br /> i . r�/lt fJk- 6189-1 <br /> 0 <br /> 61893 <br /> 61894 <br /> tv'�-/o <br /> �q <br /> i u a ( i-'o re b ecei e y (Signature) D tefTime <br /> eq <br /> �atelTlme <br /> Rehnquished by (Signature) Received by (Signature) <br /> Relinquished by (Signature) Received by Moblie Laboratory for field analysis (Signature) Uate/Time <br /> ry <br /> Dispatched by (Signature) DatelTrme ecelved#or aboratary by ! 'Date/Time <br /> =r <br /> 'fy, <br /> Laboratory ame <br /> Method of Shipment <br /> Specie, instructions r i hereby aut rix t�,ipanrepof the above indicated work <br />
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