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ARCHIVED REPORTS XR0011150
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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701
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3500 - Local Oversight Program
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PR0544217
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ARCHIVED REPORTS XR0011150
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Entry Properties
Last modified
3/4/2019 11:32:51 PM
Creation date
3/4/2019 4:39:17 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0011150
RECORD_ID
PR0544217
PE
3526
FACILITY_ID
FA0002512
FACILITY_NAME
GSG GAS & MART
STREET_NUMBER
701
Direction
E
STREET_NAME
DR MARTIN LUTHER KING JR
STREET_TYPE
BLVD
City
STOCKTON
Zip
95206
APN
14734311
CURRENT_STATUS
02
SITE_LOCATION
701 E DR MARTIN LUTHER KING JR BLVD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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i i i tfl• tt� i � i i i i i i i i i <br /> Advanced <br /> • 1�7CHAIN OF CUST ARIECORD <br /> - GeoEnvironmental Inc. Date " ("" r�Page of <br /> 4005 North Wilson Way-Stockton,Califomta-95205-(209)467-1006-Fax(209)467-1118 <br /> Client Kt+fttW O Project Manager If <br /> � 14 <br /> , N <br /> Tests Required <br /> I (A 1,e <br /> Phone Number <br /> I <br /> Samplers (Signature) < Invoice <br /> Project Name / , �,�_ AGE ci1 ��� � Client <br /> Sample Type <br /> Sample Location Date Time Water Solid No of Notes <br /> Number Description Camp Grab Air Conts <br /> ecnature \ I 0 te/Trme,5`p <br /> Relii-Kyisho by nature) Received by (Signature) D te/TirrIllt <br /> Reloqwghed b (Signature) Received by Mobile Laboratory for field analysts (Signature) Dat ime <br /> Dispatched by (Signature) Date/time cet for Laboratory Daterrime <br /> Z/J //,I <br /> OD <br /> Method of Shipment n � Lab story Name r <br /> Special instructions I hereby authorize 1`61 performance of the above indicated work <br />
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