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ARCHIVED REPORTS XR0000881
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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C
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CALIFORNIA
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300
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3500 - Local Oversight Program
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PR0544147
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ARCHIVED REPORTS XR0000881
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Entry Properties
Last modified
2/14/2019 1:59:50 PM
Creation date
2/14/2019 1:08:00 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000881
RECORD_ID
PR0544147
PE
3526
FACILITY_ID
FA0004522
FACILITY_NAME
SKIPS SERVICE STATION
STREET_NUMBER
300
Direction
S
STREET_NAME
CALIFORNIA
STREET_TYPE
ST
City
STOCKTON
Zip
95206
APN
14909501
CURRENT_STATUS
02
SITE_LOCATION
300 S CALIFORNIA ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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*CHAIN OF CUSTODY RECORD 5'Ta SHERWOOD Lass � <br /> P.O.BOX 937 <br /> 8071 N. Lander Avenue <br /> n <br /> Sherw4wdRO. Bax 937 HH-MM, CA 95324 <br /> Hilmar,CaldomRa 95324 <br /> Labs (209) 667-5258D <br /> C 0 F? P 0 A A T l O N PAX(209) 667-2581 Awn.VICKI HEIBIS p'F? Page of ¢ <br /> Lc <br /> Jab Number P.O.d Projei Name <br /> San'p6 m(S watum) Bite Address <br /> SAMPLE LOCATION DATE TIME NUMBER �TYPEFLAS SAMPLE <br /> (IDENTIFICATION) (MT UAYrYR) (HOURMIN) OONTAlNEAS COMPOSITE) MATRIX �� \ �/ REMARKS <br /> Mw-1 12-17-3 1532 ✓ ✓ <br /> MW-2 1511 / x <br /> 4945 o <br /> NW-5 1242 <br /> MW-6 1037 <br /> MW-7S 1201 ✓ / A <br /> Mw-as 1400 <br /> MW-$D1439 ✓ Fro <br /> 14W-9 122 ✓ ✓ 1.0 <br /> fo <br /> m <br /> W <br /> i Reinqu' By: S!WQNMa�1s n1�atNT/mYe�Q3/Q iJ FWcaved Br(Sgenaalu�ie) <br /> /vidRNA I <br /> Reloaquhed ey (Srgnatum) ]ae/Tme 24 HOUR t] <br /> 3 <br /> rl <br /> JZ i *j.6 a nHOL-3 <br /> By:[Signature) t]aleRme R6,oNmd gy:(si flatelrme <br /> 01STRI&MON: Original-Accompanies Shipment Canary Copy:Shwwocd Pink Copy:Samp3er NOTE Samples are discarded 30 days d*T re.Br:lts are reported unless other amangemnts are made. <br /> e <br />
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