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ARCHIVED REPORTS_XR0008304
Environmental Health - Public
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EHD Program Facility Records by Street Name
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W
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WATERLOO
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4407
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2900 - Site Mitigation Program
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PR0535375
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ARCHIVED REPORTS_XR0008304
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Entry Properties
Last modified
7/7/2020 9:23:57 AM
Creation date
7/7/2020 9:16:19 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008304
RECORD_ID
PR0535375
PE
2960
FACILITY_ID
FA0020405
FACILITY_NAME
ERNIES GENERAL STORE
STREET_NUMBER
4407
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
08710059
CURRENT_STATUS
01
SITE_LOCATION
4407 E WATERLOO RD
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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LSauers
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EHD - Public
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..� ..� mtttttttt� ■� w a� ■�■■ �� i• l• � m <br /> Advanced CHAIN OF CUSTODY RECORD <br /> f ass-3A-L3-3A-L3Pap ! ot�_ <br /> GeoEnvironmenta , Inc. D <br /> C <br /> 937 Shaw Road- Slockfon,California-95215-(209)487-1008-Fax (209)457-1118 m <br /> i I <br /> Client prof MOS m <br /> Tena Required w <br /> hone Number <br /> W <br /> Samplers (Skgnatufe) invoige' <br /> Project Name Y 1 -�-� AGE <br /> Client ❑ <br /> Sample Location Sar'PiType No.of 3) <br /> Number Description Date Time Water AirSo11d Corns. Notem r <br /> Comp Grab <br /> 0 10. . -a� X i Y, k <br /> w ' ) 1 l �- J '30 T Ltj <br /> IL <br /> a inrtuii e a l ronaturet Received by 9na uma � <br /> 11��{_—� <br /> li nqurslied by (Signature) fleceired by (Signature) Qate/Ume <br /> ru <br /> J0.d'— lma'Y" [•S�cJ�` ru <br /> eltnqu s a y (Signature Received by Mobile Laboralory for field analysla, (Skpnn4ne) Oa1mrlfima I <br /> Dispatched by (Signature) Date/l ime Flecalwad for Laboratory W D W/Tkme 1-11-11 <br /> el( <br /> Method of Shipment laboratury Name r T <br /> Speckal lnstruoflons 1 heraby auttkoriza the pertormanca of the adore Indles ad work m <br />
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