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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
Scanner
LSauers
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EHD - Public
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vanced CHAIN OF CUSTODYOCORD <br /> GeoEnvironmental, Inc. Date 1 t-zL"?s Page —A_ of �. <br /> of Northern Califomra <br /> 1803 West March Lane,Suite A Stockton,California 95207 (209)956-0254-Fax(209)95&0700 S3� j <br /> ClientProject Manager <br /> arT f'L) `k S�Tn-e5 S 1�Z vii 1 mc-K)4411 <br /> Tests Required <br /> Phone Number <br /> V0q) q5-6 -0;4 <br /> Samplers (Signature) Invoice <br /> � �'` <br /> Project Name G �a S � G t, e V r o l tT- van 8 u r-e�1 AGE 50 Client ❑ <br /> Sample Location Sample Type <br /> Date Time Sample <br /> Solid No of Ir Notes <br /> Number Description Air Conts <br /> Comp Grab <br /> I 1 <br /> I-;o-7ij16- Xo X -58B77 <br /> 1 L <br /> MW- 15- �-o—�� X Z s =- 58878 _ — <br /> r'Iw-16 ,q 16 -'0Y-- 2 X l`_ _4 58879 L <br /> 1 i <br /> Mw—l7/A X0 —VS 16=351 X �- x 1�-- 58880 _ 1 <br /> l F I <br /> MWILI-- �Ly M" Fr. 1, I1-16-qh =S ( <br /> MwIS-;Lo( 19:3 X � x - 58882 r <br /> - � <br /> T'S�MW 16 }5— v4&, 94P4n 00433 <br /> elinqu+s ed by (Signature) He y ign GG 1 <br /> � a Yq 16-7-010 <br /> t Relinquished by (Signature) cerved by (Sign ure) <br /> DatelTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) I Date/Time <br /> Dispatched by (Signature) DaletTtme Received for Laboratory by DatetTime <br /> Method of Shipment _ Laboratory Name <br /> ML <br /> Special Instructions _ _ I hereby authorize the performance of the above indicated work <br />
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