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ARCHIVED REPORTS XR0012563
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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D
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DR MARTIN LUTHER KING JR
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620
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3500 - Local Oversight Program
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PR0544216
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ARCHIVED REPORTS XR0012563
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Entry Properties
Last modified
3/5/2019 1:33:30 AM
Creation date
3/4/2019 2:42:56 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012563
RECORD_ID
PR0544216
PE
3528
FACILITY_ID
FA0003738
FACILITY_NAME
CHARTER WAY SHELL*
STREET_NUMBER
620
Direction
W
STREET_NAME
DR MARTIN LUTHER KING JR
STREET_TYPE
BLVD
City
Stockton
Zip
95206
APN
16504007
CURRENT_STATUS
02
SITE_LOCATION
620 W DR MARTIN LUTHER KING JR BLVD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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Sample Identification/Field Chain of Custody Record <br /> DELTA , , <br /> ENVIRONMENTAL CONSULTANTS,INC. , <br /> Pfo ect:G,:Z O !tJS ! T.< <br /> < < 04, W.O. y"�� `7�� <br /> Shipped by: —Cszr - ' <br /> Shippud to: — Attention of: <br /> Comments: hazardous materials suspected?(yes/no) ' <br /> 5a int Sample No.of Ana air u <br /> - Point W atlon Fink!ID 0 Dau Type Containers flegand ��, <br /> ;L1cJ f� RARAcY LvftC2 r3-.Q y A,—) <br /> M L J= , -- BZW ✓ ✓ <br /> /L % �• <br /> S.rrnplur(s){signature).( <br /> Field ID _- -- y Relinquished pr.(aigruhurl Received by;(i&4 trsrc) datemme commenb <br /> W. <br /> a <br /> 5.,,,lu,t fur shipment by:{signature{ 6-t-11(71. // �-�'j���gte�ji� Shipment method: J - <br /> I1000Ivui1 for t.ab by:(signature) n 1 Comments cr. <br /> 1 rI 411 C C t_r,�r., Ljr Receiving Laboratory:Please return original fomt alter signing(or receipt of samples. <br /> ,9 <br /> i�ii <br />
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