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ARCHIVED REPORTS_XR0008413
Environmental Health - Public
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EHD Program Facility Records by Street Name
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W
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WATERLOO
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4648
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3500 - Local Oversight Program
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PR0545864
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ARCHIVED REPORTS_XR0008413
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Entry Properties
Last modified
7/21/2020 10:00:58 AM
Creation date
7/21/2020 9:46:52 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008413
RECORD_ID
PR0545864
PE
3528
FACILITY_ID
FA0004530
FACILITY_NAME
MARLOWE PROPERTY
STREET_NUMBER
4648
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95215
CURRENT_STATUS
02
SITE_LOCATION
4648 WATERLOO RD
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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• c <br /> CHAIN OF CUS I OAECORC <br /> Geological Audit Services , Inc . . 6 . -- <br /> �� Enuironmenfa/Profession/s Date q 5 F ge of <br /> `W 11103 West March Lane Suit-A Stockton Galiforma 95207 {209)956 0264 <br /> �W <br /> ClientM 3��� <br /> +-10 W A r o #v 7'i t Protect Manager <br /> go b Mar f Tests Required <br /> Phone Numb r <br /> (�a7)gS6-0-�6 <br /> Samplers (Signature) � Invoice <br /> Prosect Name Mar Iowa I S GeoAudit <br /> Pro t N �` • <br /> Client ❑ <br /> Sample Location Sample Type <br /> Number Description Date Time Water Solid No of <br /> Camp Grab Air Con ��/ Notes <br /> V w-I i yp aN1ti't 3-6'43 11 :00 x ���M _ ' <br /> vw-1 t5lo 15': 10 X <br /> vw—I <br /> /70o 1 7)0 0 <br /> 50 73 5 <br /> I'lle rnquis e y (Srgnature) ecei a y ( rgna <br /> %'s- 'L�(w,t��'.',,'^_ Date/Time <br /> Relinquished by (Signature) �G�v �-7-C(; g: C� <br /> Received by (Signature) J <br /> Date/Time <br /> Aetinqurshed by (Srgnature) Received by Mobile Laboratory for field analysis (Signature) <br /> bate/Time <br /> Dispatched by (Signature) Date/Time Received for Laboralory by <br /> Date/Time <br /> Method of Shipment <br /> Laboratory Name <br /> c L <br /> Special Instructions Vr1 ` i Clr 114 <br /> 1 ��� lrf1 I herebyauthorize the performance of the above indicated work <br /> OPT s l <br /> XA� l-c/ <br /> I <br />
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