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COMPLIANCE INFO_PRE 2019
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0522054
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COMPLIANCE INFO_PRE 2019
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Last modified
5/11/2021 4:58:34 PM
Creation date
5/11/2021 4:55:35 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0522054
PE
2950
FACILITY_ID
FA0015021
FACILITY_NAME
HARRISON AUTO ELECTRIC
STREET_NUMBER
3245
Direction
N
STREET_NAME
WILSON
STREET_TYPE
WAY
City
STOCKTON
Zip
95205
APN
11904324
CURRENT_STATUS
02
SITE_LOCATION
3245 N WILSON WAY
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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SJGOV\dsedra
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EHD - Public
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GeoAnalytical Laboratories, Inc. <br /> 1031 Kansas Ave., Suite C Phone (209) 572-0900 <br /> Modesto, California 95351 Fax #(209) 572-0916 <br /> CHAIN OF CUSTODY 18 i I <br /> Client EN'S P Phone <br /> Address3Z- CC to: <br /> Zip <br /> PROJECT ID ANALYSIS <br /> No. <br /> of <br /> con- <br /> s D Y (signature) tain- <br /> ers Q� REMARKS <br /> sample <br /> type Sample Location <br /> 3 <br /> Date Time Grab Comp. <br /> tRlriin shby ( il nate): at Time ive ( i atur ate Time <br /> zo 2 3p �shed by (signature): Date Time Received by (signature): Date Time <br /> Relinquished by (signature): Date Time Received by (signature): Date Time <br /> Relinquished by (signature): Date Time Received by (signature): Date Time <br /> Relinquished by (signature): Date Time Received by (signature): Date Time <br /> Site Time: Drivin <br /> Start: Finish: �aS b 6 +'� �_ rt: 1' ss Finish: Z. O Total Hours: <br /> Garoli Graphics(209)5273667 <br />
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