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ARCHIVED REPORTS XR0010686
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 XR0010686
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Entry Properties
Last modified
3/5/2019 1:22:43 PM
Creation date
3/5/2019 10:45:40 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010686
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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M = M M <br /> M17z3m �� <br /> e CHAIN OF CUSTODY RECORD Bill Ta `p0 'A C-P , if°, L <br /> )� 6071 N Lander Avenue <br /> Sherwood m v� to0-4. 9�P O Box 937 <br /> [] Hilmar, California 95324 <br /> Labs (209) 667-5256 AttentionPhane <br /> C O R P O R A T I O N FAX (209) 667-2581 C u 5 s c nJ r-a1- j a. Wage j— Of <br /> Jab Number PO q Pro ect Name <br /> 5a rye Jr P,o <br /> Sam rs (Signatu Site Address <br /> ��.t. 7 a ory <br /> � QTi <br /> SAMPLE LOCATION DATELIMNUMBER TYPE SAMPLE <br /> } <br /> (IDENTIFICATION) (MTH/DAYIYR) OF (GRAB OR MATRIX �� Q� <br /> CONTAINERS COMPOSITE) tel` REMARKS <br /> (r f e v ✓ +� <br /> i <br /> C (-,wo A y <br /> L txlw+ 3 v 3 <br /> � <br /> Rel squished By (Srg a�) Date/Time Recery d By (Signature) Date/Time TURNAROUND TIME <br /> rnquished By (Signature) Datefrime R cerved By signature) Dale/The 24 HOUR ❑ <br /> i� lel--29199 1-Z/0A' -�c I G�2�io, } _)JL k48 HOUR ❑ <br /> Refrnquished By (Signature) DatelT+me Received y (Signature) Date/Trrne 5 DAY Z' <br /> DISTRIBUTION Original Accompanies Shipment Canary Copy Sherwood pink Copy Sampler NOTE Samples are discarded 30 days after results are reported unless other arrangements are made <br />
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