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ARCHIVED REPORTS XR0000886
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 XR0000886
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Entry Properties
Last modified
2/14/2019 2:08:15 PM
Creation date
2/14/2019 1:15:35 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000886
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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i <br /> QHAIN OF CUSTODY RECORD e''1T° SHERWOOD LABS <br /> P.O. BOX 937 <br /> 8071 N. Lander Avenue HILMAR, CA 95324 <br /> IL <br /> qwnwwoo P.O. Box 937 <br /> Hilmar, Califomia 95324 <br /> Labs (209 667-5258 ~' <br /> AnenBon:VICKI HI�BfS Ph-e:209-667-5258 Pae Of c <br /> C ) R P O R A T 1 ON FAX(209) 667-2581 9 <br /> ,lob Number LID Projed Name <br /> VCL4 z <br /> Samplers:(Signature) SEta Address �h <br /> �Pv <br /> SAMPLE LOCATION DATE TIME NUMBER TYPE SAMPLE O <br /> (IDENTIRCATION) (MTHIDAYIYR) (HOUR1MIN) CONTAINEiiS C(O MPOSITE) MATRIX <br /> REMARKS <br /> MW *1 ' do 41rte.b So it, 9'ao• co/ <br /> 49Z <br /> MO *% V 3,51 f No <br /> W-41 e I I ✓ D0�r <br /> MW S 01 `f5 f 006 <br /> apt <br /> MW <br /> fl <br /> MU) AiD <br /> 4 <br /> 'got p�Z <br /> 4913 <br /> q51 lyN <br /> Relin d W.(Signature) Dal ffm Roc By:(Signature) DateJFime TURNAROUNDTIME <br /> f ��0 <br /> !� 3 aF - D- <br /> Relinquished By.(Sigtiaturc) DpoEafiime Ived By:(Signature) DalWTime 24 HOUR ❑ <br /> 3 .IE o1 I• ,Z� �4 3�2101 Z 46 HOUR O <br /> linquished 9r:(Sigtiaturs) Deterrime a ived :(Signature) DatelTirne �a <br /> rd <br /> DISTRIBUTION: Original-Aocempanies Shipment Canary Copy:Sherwood Pink Copy:Samplet NOTE:Samples ale discarded 30 days atter resutts are rents are made <br />
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