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ARCHIVED REPORTS_XR0008905
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_XR0008905
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Entry Properties
Last modified
6/1/2020 2:31:52 PM
Creation date
6/1/2020 2:23:23 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008905
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 <br /> CHAIN OF CUSTODOECORD <br /> " GeoEnvironmental, Inc Date , I'w`� Page ___-,___ a 2 <br /> 4005 North Wilson Way-Stockton,California 95205-(209)467-1006 Fax(209)467-1118 <br /> Client Project Manager <br /> Ike V,ti M ` N i�b t In Tests Aequfred <br /> Phone Number <br /> dor( - 467 , 1066 <br /> Samplers (Signature) � Invoice <br /> Project Name LSF Cl��wrc }e� V�� �uir �1 � J `� AGE <br /> IV) Client ❑ <br /> Sample TyP6 Ar <br /> Sample Location Date Time <br /> Number Description CompGrabAir Solid �n of <br /> ��� r Notes <br /> r <br /> 6 1( , <br /> i <br /> LH W 714 to 7517:15" q X X F- - 170Z3_ t', <br /> Q M W -9 N to ,q ?_ou +-1 X z _..,L7�?_4—_____► <br /> r <br /> LX MW - 1 I . 101ti t7' 67 � X X 170 <br /> Qkl ItAw- 14/1 -Ib-q7 -- 7079 <br /> �rok.) <br /> 1 17077 <br /> Relinquished yi nature Receivedy rgnalur-a <br /> Ar�1 <br /> Relinquished by (Signatu Vut Ajoylew r e) DatelTime <br /> ICum PRESERVATION <br /> Relrnqurst��� �� PROPRI J11ecelved by Mobile Laboratory for field analysis (Signature) Dale►Time <br /> Dispatched by (Signature) Date/Time c ved for abora fY b Dattrrime <br /> Method of Shipment Labofatory name <br /> �yc�c[ful S�QY , GsA+rtft �.T M t Cofr� ��l f <br /> Special Inftluc Ions _ I hereby authorize the performance of the above Indicated work <br /> 1 r✓v ell to�- v��, �, -fie, <br /> Xtv� �6� <br />
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