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ARCHIVED REPORTS_XR0008895
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_XR0008895
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Entry Properties
Last modified
6/1/2020 2:33:36 PM
Creation date
6/1/2020 2:14:32 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008895
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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��- CHAIN OF CUSTODYWCORD <br /> Advanced1�' <br /> GeoEnvironmental, Inc Dated Page _ of_�___ <br /> 837 Shaw Road - Stockton, California- 95215 - (209)487 1006 Fax (209)467-1118 <br /> Client Pr } ct M ni er <br /> Tests Required <br /> P pyre umber <br /> piers ignature) 13 invoice <br /> Project Namet <br /> Uw& <br /> AG�--�`G- Client ❑ <br /> Sample Type <br /> Sample Location Date Time Water Solid No of Notes <br /> Number Description CoAir Cants <br /> Comp Grab <br /> X Z-2-1 -cr" <br /> / L <br /> D to/Time <br /> 63 <br /> 7R.,1,,n,nqu <br /> qu s e { ignature} Received y -� � --. — -- O�Q ���tDTJ� <br /> 11A _-PUMVATION <br /> hed by (Signature) Received by APPROPRTATE a arrime <br /> SPA AP,gF, 'R' O)NTATNr <br /> - ;r,5� ,•� °�---- <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysts (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time aiv d for Labor to by Ddto/Ttme <br /> /S <br /> Method of Shipment Laboratory a <br /> LA-k,45T ,"V <br /> pedaltlnstruetlo�ns� � �� �� 1�1 � i � r � � f l�) { hereby out `ze lh pert mance of the above tndscated work <br /> �J� \�� T t�� �`�1 11� �� 'o r ✓ i .. v �i-� 11, jJ /1f <br />
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