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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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TURNPIKE
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2554
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2900 - Site Mitigation Program
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PR0507894
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COMPLIANCE INFO
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Entry Properties
Last modified
9/10/2020 3:54:30 AM
Creation date
9/9/2020 4:44:48 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0507894
PE
2950
FACILITY_ID
FA0007825
FACILITY_NAME
BLOOM, DON
STREET_NUMBER
2554
STREET_NAME
TURNPIKE
STREET_TYPE
RD
City
STOCKTON
Zip
95206
CURRENT_STATUS
01
SITE_LOCATION
2554 TURNPIKE RD
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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Bill To' <br /> CHAIN OF CUSTODY RECORD <br /> Sherwood 8071 N Lander Avenue <br /> 411 <br /> P.O. Box 937Hilmar, California 95324 <br /> LaS (209) 667-5258 Attention: Phone: <br /> C 0 P P 0 R A T 0 N FAX (209) 667-2581 arc k J�/��S �'} �r 5-bq 0 Page of <br /> Job Number: P.O.k Project Name <br /> Samplers:(Signature) Site Address _ �P <br /> A �• <br /> SAMPLE SAMPLE NO. P <br /> NUMBER DATE TIME TYPE SAMPLE INFORMATION OF � � REMARKS <br /> CNTRS <br /> Id v- ! (° �L t I )I ; �L��k'_ /\ <br /> Relinquished By:(Signature) Date/rime Received By:(Signature) Date/Time Ship Via: <br /> Relinquished By:(Signature) Date/Time Received By:(Signature) Date/Time <br /> TURNAROUND TIME: <br /> Relinquished By:(Signature) Date/Time Rep ived By,Laboratory Date/Time � 'Q 24-HR IJ 48-HR ❑5-DAY U 10-DAY <br /> DISTRIBUTION:Original-Accompanies Shipment. Canary Copy-Sherwood Pink-Sample( NOTE:Samples are discarded 30 days after results are reported unless other arrangements are made. <br />
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