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ARCHIVED REPORTS_XR0008890
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_XR0008890
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Entry Properties
Last modified
6/1/2020 2:49:10 PM
Creation date
6/1/2020 2:10:26 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008890
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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i <br /> 7� 37 <br /> TmmwEmlo C,HAI OF CUSTODY RECORD Page of� <br /> Environmental and Geotechnical Consultant 555 M��ntgomery Street,Suite 1300,San Francisco,CA 94111 Ph 415.955-90401 Fax 415-955.9041 <br /> 2 ThejItre Square,Suite 216,Orinda CA 94563 Ph 925-253-49801 Fax 925.25349=5 <br /> 501 14th Street,3rd Floor,Oakland,CA 94612 Ph 510474-45001 Fax 510-874-4507 <br /> Site Name <br /> Job Number 5 c t ,a — 9 p P4 Analysis Regvesteda�t ' <br /> Project Managed ac t �� <br /> Samplers V <br /> Recorder(Signa tu gtiireCL <br /> d) j! f f No Containers <br /> Matrix ! $Preservative 'a � <br /> M mmField Sampleo �Identrfication NoDate' Time Lab Sample No I u _ ! R :«erra <br /> 3 P- Y _ 5"-HI <br /> ! <br /> IN <br /> -JS - t�- X <br /> -a- 0� oto <br /> I <br /> 1wngws d by (Si n ture) r Data { Time/, Received y (Signa Date Time <br /> C t f U Ll <br /> Rei4uished by (Signature) Date ,' Time Received by (5i6natur Date Time <br /> I 4 <br /> I <br /> Relmquished by (Signature) Date Time Received by Lab (Signature) Date Time <br /> 3 If <br /> Sent to Laboratory(Name) if ;f Method of Shipment Lab couner Fed Ex E]Airbome UPS <br /> Laboratory Comments/Notes { E]Hand Camedl:]Pnvate Couner(Co Name) <br /> White Copy-Original Yellow Copy-Laboratory Pink Copy-Field COC Number 003277 <br />
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