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ARCHIVED REPORTS_XR0006950
Environmental Health - Public
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EHD Program Facility Records by Street Name
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Y
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YOSEMITE
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420
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2900 - Site Mitigation Program
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PR0537485
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ARCHIVED REPORTS_XR0006950
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Entry Properties
Last modified
7/27/2020 5:42:28 PM
Creation date
7/27/2020 3:59:20 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006950
RECORD_ID
PR0537485
PE
2957
FACILITY_ID
FA0021568
FACILITY_NAME
FORMER RAINWATER CAR WASH
STREET_NUMBER
420
Direction
W
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
APN
21931206
CURRENT_STATUS
01
SITE_LOCATION
420 W YOSEMITE AVE
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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LSauers
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EHD - Public
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i <br /> CHAIN O CUSTOE&ECORD <br /> Advanced ��6 <br /> LA <br /> GeoEnvironmental, Inc. )ate Page of <br /> 837 Shaw Road-Stockton,California-95215- (209)467-1006- Fax (209)467-1118 rr'3 7 - 0 <br /> '7 - 0 <br /> Client i c � Projectcl-�� Tests Required <br /> Zne Nu r <br /> ") <br /> Same ers (Sig re) Invoice <br /> Project Name I' AGE k <br /> Cilertt ❑ <br /> Sample Type <br /> Sample Location No of <br /> Number Description Date Time Water aur Solid No <br /> Notes <br /> Comp Grab <br /> (�t G J9 <br /> k111 ` , toad <br /> hoz — <br /> e rs a ��gnature starve y ignature � e�frrrtsa�� <br /> Relinquished by (Signature) Received by (Signature) DatelTit/me <br /> __/TRelinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) ©ate/Time <br /> Dispatched by (Signature) Date/Trme Received for Laboratory by OateJ me <br /> 'LLQ �.d� y. <br /> Method of Shipment t 0\rely-r'�;c) Labor V <br /> Name <br /> Special Instructions { �,(, �+'� rr I hereby authorize th rformance of the above ind d work <br />
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