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ARCHIVED REPORTS XR0010672
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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749
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3500 - Local Oversight Program
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PR0544218
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ARCHIVED REPORTS XR0010672
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Entry Properties
Last modified
3/5/2019 12:08:57 PM
Creation date
3/5/2019 10:38:42 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010672
RECORD_ID
PR0544218
PE
3526
FACILITY_ID
FA0003870
FACILITY_NAME
SRH FOOD & GAS
STREET_NUMBER
749
Direction
E
STREET_NAME
DR MARTIN LUTHER KING JR
STREET_TYPE
BLVD
City
STOCKTON
Zip
95206
APN
14734309
CURRENT_STATUS
02
SITE_LOCATION
749 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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ill To <br /> CHAIN OF CUSTODY RECORD <br /> f <br /> Sherwood $071 N Lander Avenue <br /> P 0 Box 937 <br /> Hilmar, California 95324 <br /> Labs (209) 667-5258 Attention � Phonl,, ,,,,-C 0 R R 0 R A T r 0 N FAX (209) 667-2581 f L1�SSE'� .>>7 /syr Page of <br /> Job Number Protect Name !� - <br /> ���E <br /> Samplers (Signature) PO Number 1 y <br /> SAMPLE SAMPLE NO <br /> NUMBER DATE TIME TYPE SAMPLE INFORMATION OF REMARKS <br /> CNTRS <br /> L f3 m - If I-IV-9 It'Wriv, 41A 4, ?C <br /> rIN - 6 ol'It "- 1C Voa trs.ar►[ed fjnr riC�d '�� <br /> lA - <br /> e 01 T- <br /> 90, <br /> ''F <br /> Relinquished By (Signature) Date/TimeRec ived By (Signal e) Date/Time Ship Via <br /> 14111 r <br /> Reb guish d By Si nature)- edelTr / Received By (Signature) Date/Tome <br /> ff �L 11CQ Q `l!r' TURNAROUND TIME Date <br /> Relinquished By (Signature) ate/rime Received By (Signature) Datefrime <br /> ❑24 HR ❑5-Day 10-Day <br /> DISTRIBUTION Original Accompanies Shipment Canary Copy Sherwood Pink Sampler NOTE Samples are discarded 30 days after results are reported unless other arrangements are made <br /> I <br />
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