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ARCHIVED REPORTS_XR0012120
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_XR0012120
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Entry Properties
Last modified
10/10/2020 11:26:53 PM
Creation date
7/9/2020 8:55:01 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012120
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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CHAIN OF CUSTODRECORD <br /> � Advanced � <br /> GeoEnvironmental, Inc. Date � y �� Page <br /> 837 Shaw Road- Stockton, California- 95215- (209)467 1006- Fax (209) 467-1118 2 <br /> r , P�ect Mana er <br /> Client W'` ��� 14 <br /> Tests Required <br /> 1` l <br /> P one N mber <br /> 7 1/Z7- 140 <br /> Samplers (Signature) Invoice <br /> AGE [k <br /> Project NameSample Type�11 Client E]O ` '1 'TIcJ!✓t- <br /> Sample Location Date Time Water Solid NO of �� � � N Notes <br /> Number Description Comp crab Air Conts <br /> I �A <br /> elinq is e y ign re) ecewe y ignature aterri e <br /> Relinquished by (Signature) Received by (Signature) Daie ime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Daterfrme Received for Laboratory b Date/Time <br /> Method of Shipment La ory Name <br /> �\ I hereby authorize the performance of the above indicated work <br /> Special Instructions r�l <br />
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