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ARCHIVED REPORTS XR0001060
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 XR0001060
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Entry Properties
Last modified
3/4/2019 8:55:09 PM
Creation date
3/4/2019 3:13:23 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0001060
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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S LL OIL COMPANY *HAIN OF CUSTODY RECORD Date. 'f. 00~ <br /> RETAIL ENVIRONMENTAL ENGINEERING - WEST Setlal No: Page 6 ° � <br /> Site Address: Analysis Required LAB: <br /> �Zo W. Chi-►r4C�lr 5-� G(C�M <br /> 1c,^ <br /> A P Coc 1166 1 L CHECK ONE(1}NOX WILY Cf/Df TURN AROUND 1[ME <br /> . 9g991a(s7 G W MonNorino ❑ a461 z{hour* ❑ <br /> Shell Engineer: Phone No.: SheInr.flloallon 4441 <br /> +n� 'sq) 645-930 fo „� w �6 noun [i <br /> KZt," i'�i h Fax th o a <br /> Sep Ctmdfy/Olrporal ❑ "41 11 doy� afmal} <br /> Consullani Nama S-Address: co water <br /> CAM81tlA r ryv1r,0w4 &STA-%.- ' C.Hni .d�Y,tiac. R' 4 /443 <br /> .�. 2 NO GA Cloully/Olepo�al ❑ other ❑ <br /> Phone No.: v to soo/Ali Rem.of Sy: ❑ A153 <br /> Consullanl ConlaCi: (yon)9S.;:*SS 9V, " N cd O A M norE Ncllfy Lab at <br /> Au I i Y CpoL. Fax 0:I•M)a�f-64 9 p Q u1 wolstRom orsyl ❑ u55 loon atlotrlbl.of <br /> O a M 2I/46 his 1A1 <br /> Comments: n v to a+yam <br /> M z Olh.r ❑ <br /> O p <br /> o c UST 'AGENCY: <br /> Sampled by: . (� m 21 a o 4" c Q <br /> Q d 00 to <br /> o c "o SAMPLE <br /> Printed Name: "- = o .a ' V) o 8 a MATERIAL <br /> — a E CONDITION/ <br /> _r, No of = z w 0 4i o �' a m o DESCRIPTION <br /> Sample ID Dole loll water All 0. a <br /> o U Q U COMMS <br /> cants ►- ►- m y <br /> Lo25 6 <br /> x all <br /> 12,(5 <br /> !2(5 vy� wscrja UaA <br /> SPT +w - taw <br /> jRQlqUsj9d;8y(s <br /> U" Received(sl nal re) Printed N me: Dake. xat re)�� Prinl�e Nnme. , Dalai� 1lime: aofPllnled a Dale Re a (slgna r I d Name: DI ): C. c�Q rL rims. =3 <br /> G w—�—a— ; ti��'' �J lime. prinlad Nnrne: Dole: <br /> Date- R elved slgnalule): <br /> Relinquished By(slgnalure): Pllnled Name: 1lme: <br /> Time- <br /> U I c l •vCU510py W1111 11,1VQ19E AUD RESUIS <br />
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