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ARCHIVED REPORTS XR0010689
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 XR0010689
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Entry Properties
Last modified
3/5/2019 11:43:18 AM
Creation date
3/5/2019 10:46:58 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010689
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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..� .� � �■ tttttttttt� �� �� ■lel � <br /> 1WHAIN OF CUSTODY RECORD 10 BillTo, 4,z l� ���, �, NEW <br /> — <br /> 8071 N Lander Avenue <br /> Sherwood <br /> P O Box 937 C5 15 7 <br /> Hilmar, California 95324 <br /> Labs (209) 667-5258 Attention Phone <br /> C O R P O R A T I O N FAX (209) 667-2581 �c� r ( ! S � ���7 Page of-/ <br /> Job Number PO # Protect Name <br /> Sample Signatur Site Address <br /> NUMBER TYPE �` O <br /> SAMPLE LOCATION DATE TIME SAMPLE t�, 0 r <br /> (IDENTIFICATION) (MTH/DAYNR) (HOUR/MIN) F (GRAB OR <br /> CONTAINERS NCOMPOSITE) MATRIX REMARKS <br /> Cc.."/)v `f_y so r <br /> CW/n w- 7 /,0.. 3/" 1 ✓ r ✓ <br /> Retinqui ed By _(sdnaluir Daterrime Received By (Signature) DatelTime <br /> A�11 TURNAROUND TIME <br /> f� linquished By (Signature) ate/(me 7ev;�y'(Signature) DatelTi a24 HOUR LI 48 HOUR ❑ <br /> R linquished By (Signature) Date/Trme Received By (Signature) atelTime 5 DAY 8— <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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