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ARCHIVED REPORTS_XR0008857
Environmental Health - Public
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EHD Program Facility Records by Street Name
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V
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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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ARCHIVED REPORTS_XR0008857
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Entry Properties
Last modified
6/1/2020 2:31:47 PM
Creation date
6/1/2020 2:05:38 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008857
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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LSauers
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EHD - Public
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i i�i i f• f• i i � i i i i i i <br /> Advanced CHAIN OF CUSTOARECORD <br /> GeoEnvironmental, Inc. Date 10^ y` ^r�r� Page of <br /> i — ( of Noilhr rpt Cuhrnnurt <br /> 1603 West March Lane Suite A Stockton Californiac on Caf 95207 {209}956-0264 Fax(209)956 0700 ,-G1/6 <br /> ClientProtect Manager <br /> �arTw�a�� � S�T in t s 5 Required <br /> Phone Number <br /> _ Samplers (Signature) Invoice <br /> Project Name ��a4e �.�lellrol4 { �a� �u�^t� 'V ' / i AGE= [� <br /> Chef it [_ <br /> Sample Type <br /> Sample location __ __ <br /> Date Time Water Solid No of /'� <br /> Number Description ---- -- Air Con#s ��/ Notes <br /> Comp Grab <br /> I <br /> Mw - 6Io- -qs f°'5�� ' �,5�. n __ -- — - — 57225 <br /> — - —J - <br /> Mw-7/1© 57226> -qy _ t5.�5 <br /> OW -7/10-5 -7.5' 15 =�o 2 — —y _ _ 57227 <br /> M W_10i([05 ��� 15-10 X 2 X 57228 <br /> — F <br /> I — <br /> leluiqui- led )y (SF9+Fah re) rFecc-i rt� ,ipnnture ntP�iF rA <br /> lie inquished ny (Sign ure) flec ve 'by (Signature --- <br /> � / L)atrllFmP Y <br /> Relinquished by (�gnature) tie rued by Mobile Laboratory for field Analysis (Signature) {)atelTimP <br /> Dispatched by (Signature) Date/Time Received I Laboratory by Dale/Time T <br /> Method of Shipment Laboratory Name <br /> ++y�--��--����___. M`CR►nib+.[ <br /> Special Instructions gi��{ii}wttrlta + J yi, -4 1 hereby authorize the performance of the above Fndic-iied work <br /> L -a�l:� <br /> i ri uf..f J1:4 <br />
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