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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0541653
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Last modified
7/8/2020 3:43:40 PM
Creation date
7/8/2020 3:35:53 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0541653
PE
2965
FACILITY_ID
FA0023871
FACILITY_NAME
TOP FILLING STATION
STREET_NUMBER
101
Direction
S
STREET_NAME
WILSON
STREET_TYPE
WAY
City
STOCKTON
Zip
95205
APN
15125307
CURRENT_STATUS
01
SITE_LOCATION
101 S WILSON WAY
P_LOCATION
01
QC Status
Approved
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EHD - Public
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Advanced GeoEnvironmental, Inc. www.advgeoenv.com CHAIN OIF CUSTODY RErO(RD <br /> 37 Shaw Road,Stockton,California 95215 s Phone(209)467-1006 a Fax(209)467-1118 Date: �� �iJ Page_J)of <br /> LJ ' l <br /> 81 Thor Place,Brea,California 92821 a Phone(714)529-0200 a Fax(714)529-0203 ko r� <br /> ' ❑ 2318 Fourth Street,Santa Rosa,California 95404 • Phone(707)570-1418 e Fax(707)570-1461 Analysis Required <br /> ® ❑395 Del Monte Center,#111,Monterey,California 93940 • Phone(800)511-9300 •Fax(831)394-5979 <br /> Project Nam Project Manager <br /> ,4 C i <br /> Client Sampler lipitials&signature) <br /> Invoice to: AGE ❑ Client Lab Project No.: <br /> Sample ID/Location/Description Date Time Matrix Number Notes <br /> V10^Ikat Z. s 1 <br /> 1 > e� 1 101'5 1 3 <br /> -� z- <br /> 17 <br /> 7 <br /> Relinquished by: Date: Timp: laboratory: 72 <br /> ZZlOle <br /> Courier: Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: / Date: Time: <br /> Requested Turn Around Time(circle): 24 hours 48 hours 72 ho s 5 ys(stab ) Other: Matrix Codes: A=Air W=Water S=Solid <br /> Special Instructions to lab: y /} e� 7 _ I herebyauthyy ' e the erformance of the above indicated work. <br /> �j' JT•'w+ ,�I,j UW'^ I e- s Z&4 '�"'�C. / p I <br /> G7 5 � j r llif kT� r- C3 r� t 1`ue� t F �- <br /> 1777 <br /> /'J <br /> Geotracker EDF to:0 geo cker@advgeoenv.com ❑ Global ID: <br />
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