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ARCHIVED REPORTS_XR0012108
Environmental Health - Public
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EHD Program Facility Records by Street Name
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W
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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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ARCHIVED REPORTS_XR0012108
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Entry Properties
Last modified
10/10/2020 11:24:44 PM
Creation date
7/9/2020 8:48:57 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012108
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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LSauers
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EHD - Public
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t <br /> Advanced CHAIN OF CUSTOD RECORD <br /> GeciEnvironmentai, Inc. Date 5LI () page -Z- of <br /> 837 Shaw Road -Stockton, California 95215-(209)467-1006- Fax (209) 467-1118 i <br /> Client Project Manager <br /> ��,` Tests Required <br /> Phone Number <br /> ;i L--I ul -lcx%C." <br /> Samplers (Signatu Invoice <br /> Project Name <br /> f AGE Q` [7, <br /> Client ❑ <br /> Sample Location Date Time Sam ype Solid No of '� N Notes <br /> Number Description Water I Air Conts <br /> Comp Grab <br /> MID MW ,� ( 1 'I 3 X � � � <br /> Nw i�W l I <br /> e En Es e i nat re eaeiva y ignature DatojEme <br /> Relin ed by (Signature) Received by (Signature) Da alTl11�9 <br /> l Z) <br /> Relinquished by (Signature) Received by Mobile Laboratory for held analysis (Signature) C Date(T e <br /> Dispatched by (Signature) DatelTrme Received for Laboratory by / DatelTEm9e <br /> S.. ' ✓ i -D J 1 ", <br /> Methodofof Shipment Laboratory me <br /> v .L <br /> Spectai Instructions ( + ' 1 hereb authorize the performance of the above indicated work <br />
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