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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 GeoEnvironmentals Inc. www.advPeoenv com CHAIN OF USTODY RECORD <br /> 9837 Shaw Road,Stockton,California 95215 • Phone(209)467-1006 • Fax(209)467-1118 Z Page—1 Ofl <br /> ❑ 381 Thor Place,Brea,California 92821 •Phone(714)529-0200* Fax(714)529-0203 Date: <br /> ❑ 2318 Fourth Street,Santa Rosa,California 95404 o Phone(707)570-1418 • Fax(707)570-1461 Analysis Required <br /> F-1395 Del Monte Center,#111,Monterey,California 93940 • Phone(800)511-9300 a Fax(831)394-5979 <br /> El <br /> Project Nem i1> < Project Manng + <br /> Gl r <br /> Client Sampler(int,"s s&signature) 1 �� <br /> 1 <br /> Invoice to: AGE ❑ Client Lab Project No.: <br /> Sample ID/Location/Description Date Time Matrix Number Notes <br /> V11 A <br /> Lin <br /> 114 <br /> ua�)O-r— —:E <br /> ii <br /> sl mow_1 Lp�ci -I <br /> zt )raj <br /> Relinquished by: ate: Tim'_e�: ��--y Laboratory: <br /> .� ��— l+�Cd E'' ay <br /> Courier: ON"�A Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: Date: Time: <br /> Relinquished by: Dale:- Time: Received by: ^ �, + ,,' Date: Time: <br /> Requested Turn Around Time(circle): 24 hours 48 hours 72 hours 5 days(standard) Other: Matrix Codes: A=Air W=Water S=Solid <br /> Special Instructions to lab: -` t 1 i <br /> E �JGLt1.eJ/L. C..r V , — I hereby authorize the performance of the above indicated work. <br /> J <br /> IA; `Uy <br /> . <br /> Geotracker EDF to:❑ geotracker@advgeoenv.com ❑ Global ID: <br /> vl/ <br />
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