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ARCHIVED REPORTS_XR0008899
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_XR0008899
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Entry Properties
Last modified
6/1/2020 2:36:43 PM
Creation date
6/1/2020 2:15:49 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008899
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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Advanced CHAIN OF CUSTODfRECORD <br /> GeoEnvironmental, Inc. l� Date Page <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 <br /> client Pro ct Manager <br /> L � Tests Required <br /> Ph ne Number <br /> 209 467-1666 <br /> Samplers (Slgnat re) 4 Irnrolce <br /> Project Name e�ASE ' VO � Client� tient 0 <br /> ❑ <br /> Type Typ \� <br /> Sample Location SampleNo of <br /> Number Description Date Time Cam�Vate(r qtr solid Conts Q ''J 63354 <br /> W3- IF 9'39 X I 63355 ' <br /> x+13-�� 1S' 9;f 3 <br /> r <br /> 2s'' I x X X 63356 <br /> ccs <br /> 'H 63357 <br /> eh uT y net e) ]Receivedy ignatu11 Ac IO&GI <br /> �SO�r�0 Lii <br /> Relinquished by [Signature) GOOD C0NDlTION CeAPpROPftlATE <br /> Relinquished by (Signature) R ile LaYoratory for field analysis (Signature) ; <br /> 63359 <br /> Dispatched by (Signature) Date/Time Received tot Laboratory by <br /> c i <br /> Method of Shipment L oratory Name <br /> l�Alr Ou ft1 <br /> Special instructions I he h* PzetlLhe perfo mance of The above indicated work <br /> i <br />
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