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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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WILSON
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101
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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 GeOEnvlronmental9 Inc. www.advi4eoenv.com CHAIN OF CUSTODY RECORD <br /> 1 837 Shaw Road,Stockton,California 95215 a Phone(209)467-1006 a Fax(209)467-1118 Date: 2 Page Of <br /> 381 Thor Place,Brea,California 92821 a Phone(714)529-0200 a Fax(714)529-0203 S,i s'} <br /> ❑ 2318 Fourth Street,Santa Rosa,California 95404 a Phone(707)570-1418 a Fax(707)570-1461 Analysis Required <br /> 395 Del Monte Center,#111,Monterey,California 93940 a Phone(800)511-9300 e Fax(831)394-5979 <br /> Project Nam Project Man <br /> Client Sampler(' i[ials&signature) <br /> a <br /> I Lab Project No.: f� <br /> Invoice to: AGE ❑ Client (- <br /> Sample ID/Location/Description Date Time Matrix Number Notes J <br /> bo- 17 bt-1 2- IYr <br /> fel tj 1_7 <br /> vo --3ck ` moi �i ' '� g lu t- r� p_2, <br /> Relinquished by: Dare: Tit e: Laboratory <br /> Courier: Received by: Date: Time: <br /> Relinquished by: Dace: Time: Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: t� / Date: Time: <br /> Requested Tum 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: gam _1 s I ,a l 1 e 1,a t,._ g g� „_? �0 ��„� I hereby iie the performance of the above indicated work. <br /> Geotmcker EDF to: D geovacker@advgeoenv.com ❑ Global ID: V <br /> X41 r <br />
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