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ARCHIVED REPORTS_XR0006399
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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1002
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3500 - Local Oversight Program
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PR0545915
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ARCHIVED REPORTS_XR0006399
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Entry Properties
Last modified
9/29/2020 10:21:06 PM
Creation date
8/4/2020 2:39:09 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006399
RECORD_ID
PR0545915
PE
3528
FACILITY_ID
FA0025964
FACILITY_NAME
CONRADY PROPERTY
STREET_NUMBER
1002
Direction
N
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
STOCKTON
Zip
95203
CURRENT_STATUS
02
SITE_LOCATION
1002 N YOSEMITE AVE
QC Status
Approved
Scanner
LSauers
Tags
EHD - Public
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r- _M- r r r r r r r r r mm <br /> CHAIN OF CUST RECORD <br /> - � Geo- o ica! Audit Se rices 9 Inc . Date f0'� -`� 3 Page 2: of Z <br /> EnPMOSS101781s <br /> — , SELAW 1803(Nest March Lane Suite A Stockton California 95207 (209)956 0264 <br /> r -- low <br /> _ -- - Project Manager Tests Required <br /> M q -�v i e C 0-vl w rz d� - - Vi'C C.�'1 e Y tr e rn <br /> k - _ <br /> - _ Phone Number <br /> Samplers (Signature) /�� / % / invoice <br /> �ProjectName=��� Yid sprt�iG� 5 i aTiD� I Client ❑ <br /> _ / <br /> - Sample= Location - - - pate Time Wa eple Type Solid No of Notes <br /> _Number _ Descnption _ - Comp Grab i Air Conts <br /> ti w 3 - 35=, x <br /> _-oMw1 ,14 - - w o l <br /> -`Mw ~40_ <br /> -- nq-uisha by Signature} eceive y (SignatureDate/Time <br /> a t <br /> Relinquished by (Signature) - Received b (Signature) DatelTime <br /> =-=Relinquish - - T Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) -- DatelTEme Received for ory by fG ate me <br /> Method of Shipment _ - Labor e <br /> Specaal Instructions — - eby authorize the performance of the above indicated work <br />
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