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COSZGWLWK
Environmental Health - Public
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EHD Program Facility Records by Street Name
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PISA
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2357
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2500 – Emergency Response Program
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COSZGWLWK
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Entry Properties
Last modified
3/4/2021 1:02:00 PM
Creation date
3/4/2021 12:55:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
COSZGWLWK
PE
2546
FACILITY_NAME
RESIDENTIAL HOUSE
STREET_NUMBER
2357
STREET_NAME
PISA
STREET_TYPE
CIR
City
STOCKTON
Zip
95206
APN
16627028
ENTERED_DATE
11/21/2020 12:00:00 AM
SITE_LOCATION
2357 PISA CIRCLE, STOCKTON, CA
RECEIVED_DATE
11/21/2020 12:00:00 AM
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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CASTLE ANALYTICAL LABORATORY CHAIN OF CUSTODY <br /> Location: 2333 Shuttle Drive, Bldg 908/909, Atwater, CA 95301 Certificate No.2480 <br /> Mailing Address:2333 Shuttle Drive,Atwater,CA 95301 PAGE OF� <br /> Phone: 209)384-2930 - Fax: 209 500-1848 <br /> Customer: PG&E Stockton o REQUESTED ANALYSES Method of Shipment: <br /> Address: 4040 West Lane <br /> = o U) OEU Uef-,>E 0 <br /> City/State/ZIP: Stockton. CA 95204 x w <br /> Lu �' N T N o Notes: <br /> Phone / FAX: (209) 942-1401 ? Q co o o N <br /> o CD cc z `� <br /> Proj#/ PO#/Global ID: 23 'l I &A C�2e D a_ � — o <br /> Report Attention: Alex Steele/ a Larsen Q a = w m o m o <br /> Sampler Signature: 0 o' m wco m <br /> Sampler Printed: {� ,� <br /> Jc= L2b�� 0 ~ N <br /> x o Z <br /> LU W <br /> Lab ID# SAMPLE ID 1 DATE TIME DE <br /> SCRIPTION/LOCATION m OBSERVATIONS/REMARKS <br /> P.,5(--3t- C 4 �C�� �-21 °J:CU 1 OZ O C L <br /> ota number o containers <br /> Signature Printed Name Date Time Company Name submitted to the laboratory <br /> Relinquished by: &-21- n � Turn Around Time: <br /> Received by: �52� Z3,70 :470 24 Hour <br /> Relinquished by: 48 Hour 0 <br /> Received by: 3 Day <br /> Relinquished by: 5 Day (Normal) <br /> Received by: Special: <br />
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