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ARCHIVED REPORTS_XR0008908
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_XR0008908
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Entry Properties
Last modified
6/1/2020 2:36:16 PM
Creation date
6/1/2020 2:24:34 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008908
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
Tags
EHD - Public
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� � � � � I• � � � � � � ■t■� s� Iififififfiiffl tI� tltitititil111U <br /> Advanced CHAIN OF CUSTOECQ.QD <br /> - <br /> GeoEnviron mental, Inc Date Y Pagetor <br /> —1k <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 <br /> Project Manager <br /> Client V MG se C S Afb r h Tests Required <br /> Phone Number [04, <br /> Wr <br /> Samplers {Signature a Invoice <br /> 49"-e <br /> ' ` + AGE <br /> V461 Protect Name C � 14 �.0� / Cbew❑_ <br /> Sample Location m Sample Type No of Nates <br /> Number Description Date Tie Water Air Solid Conts r <br /> Comp Grab <br /> 02844 <br /> 77C <br /> 02845 <br /> 02846 — <br /> C�� �✓ Z— 3� r <br /> 02847 <br /> 1110 PPli,i!a!tTE <br /> HEAD FWT <br /> e in e y (Signature) Received by (SignatureDatelTime <br /> 3 c� —fl <br /> Relinquished by (Signature) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatetTime <br /> Dispatched by (Signature) Date/Time R c ved_tor Laboratory Datefrime <br /> Method of Shipment Laboratory Name <br /> ovevrti : f- nc ( 4MLF �Cff <br /> Special Instructions _ r I hereby authorize the perlormancil of the above Indicated work <br /> IZAL V"NO)fi-e <br /> 1 <br /> / L t, <br />
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