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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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s r� two � � i• � ■� � � �■ i• i, � i• � � 1• � <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date 'q3 Pqp of <br /> 937 Shay Fiend-Stockton,Cetifom€e -96215-(209)467-11009 -Fax(2109)467-1118 v <br /> N <br /> CIl$rtttoy Q $ `I[ [ 118 r W <br /> Tests Required <br /> Phoge Num E <br /> b - 0 0 m <br /> Samplers.(Signature) Invoice <br /> Project Name � oqtr--> v I`r 1(Vl. C � — AGE <br /> � <br /> Ckertt <br /> n <br /> Sample Location ample Type � <br /> No.of <br /> Number Description Date l�rne Water Air Solid Cottle NoUs m <br /> Corny Grab M <br /> c <br /> —7-30-63 <br /> V'zw <br /> ..Bn f` .ou a• �.ri�i�iw:o. n..�w�o nr .rl.�u'w-apap� � <br /> /// <br /> Ralinq hod by {Sipneture] Received by (Signature) DateMme N <br /> N <br /> Relinquished by { lgnature] Received by Mob[(*Laboratory Ier 11014 Malys <br /> €e {840naDitr*] Datefrime N <br /> ti <br /> 13 <br /> DiapalcW by (Signature] Date/Time JFkvc41wed for Labwatory by DatelTlme M <br /> _ <br /> / f -. <br /> DMaihod of Shlpmenl Laboratory Name I <br /> vve C's�n' <br /> 5peoial tert►uctlana 1 hereby authorize the performan-ce of 1be above Indicated work <br /> m m <br />
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