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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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VAN BUREN
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424
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3500 - Local Oversight Program
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PR0545786
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FIELD DOCUMENTS
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Last modified
6/1/2020 1:57:20 PM
Creation date
6/1/2020 1:50:45 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0545786
PE
3526
FACILITY_ID
FA0004969
FACILITY_NAME
CHASE CHEVROLET
STREET_NUMBER
424
Direction
N
STREET_NAME
VAN BUREN
STREET_TYPE
ST
City
STOCKTON
Zip
95205
CURRENT_STATUS
02
SITE_LOCATION
424 N VAN BUREN ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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Advanced ob-�0339� CHAIN OF WSTODY RECORD <br /> - < GeoEnvironmental Inc. Date /y JZ-Pa e <br /> s or_� <br /> 837 Shaw Road- Stockton. California- 95215 - (260 467-1006- Fax (209) 467-1118 <br /> Client = J lect Manager <br /> Tests Required <br /> Phone Number <br /> A WKS u�0 <br /> Samplers: (Signature) Invoice: <br /> Project Name C4K(i, Vk Ql AGE--N <br /> Client ❑a <br /> Sample Location Sample Type <br /> Date Time Water Air solid Conts. <br /> Number Description Notes <br /> Comp. arab. <br /> 41V <br /> OZ- <br /> VGAS PrG td`TAt S <br /> _ t r a <br /> I ak <br /> I c u S YLE Q11fl, CG dlAt; fl <br /> q. urate ece va y: gnelure <br /> '� <br /> 2 Dete/Tlm <br /> Rall qula ed hy. (S gn Received by: (Signature) 5-rAAlO. T• A °•� T e ,40 <br /> I Dele/TI o <br /> e inqu shed by: Signature Received by Mobile Laboratory for field anely:la: (Signature) Date/Tlme <br /> Dispatched by: (Signature) Date/Time a el ed for a oratory by: Dale/Tlme <br /> Method of Shipment: <br /> CSI abora or Name <br /> cL <br /> ecle`IntUucgona: <br /> v �/1� � I her euth Ize the Perfoc once of the above Indicated•work. <br /> . t" C1 (`—`I�� ` � - <br /> (I � <br />
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