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ARCHIVED REPORTS_XR0007352
Environmental Health - Public
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3500 - Local Oversight Program
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PR0545741
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ARCHIVED REPORTS_XR0007352
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Entry Properties
Last modified
6/8/2020 12:53:17 PM
Creation date
6/8/2020 12:35:44 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007352
RECORD_ID
PR0545741
PE
3528
FACILITY_ID
FA0006284
FACILITY_NAME
YAMADA BROS INC
STREET_NUMBER
15406
Direction
S
STREET_NAME
TRACY
STREET_TYPE
BLVD
City
STOCKTON
Zip
95206
APN
18917007
CURRENT_STATUS
02
SITE_LOCATION
15406 S TRACY BLVD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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LSauers
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EHD - Public
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CHAIN OF CUSTODREC <br /> ( Advanced ORD <br /> = 7 a� sage �— —� <br /> GeoEnvironmental, Inc. Dateof <br /> �a,j pppa <br /> 837 Shaw Road -Stockton, California- 95215 - (209)467-1006- Fax (209)467-1118 <br /> Client Pro ect Manager <br /> ci �.- �:d 2r'i � Tests Required <br /> Phone Number r1 <br /> 7- IVC'/k1 <br /> Samplers (Signature) y Invoice <br /> r <br /> Project Name y �4 + / - <br /> Client <br /> p <br /> Sample Location Sample pe No of 411 <br /> Date Time Number Description Water Air Solid Conts j v Notes <br /> Comp Grab <br /> 43 /ogA-707- <br /> elin u s ed b ignaturReceived by ignature Dateffirne <br /> No —?- �- o/tvf�v <br /> Rehn wished by (Signature) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Rece ved for Laboratory Da (Time <br /> Method of Shipment LabOratO ame <br /> t / <br /> Special instructions tis p�" L:` all, I <br /> t h$Peby a horize the performancl of the above indicated work <br /> C"'OD CONDITION <br /> h <br /> i7.,,�,1WRLVATRD 1,N LA13_FR8SLUVED IN LAd <br />
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