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ARCHIVED REPORTS XR0010717
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 XR0010717
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Entry Properties
Last modified
3/5/2019 12:55:41 PM
Creation date
3/5/2019 10:56:58 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010717
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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7zt -7 770 <br /> WAIN OF CUSTODY RECORD Q 10-7 7-7 <br /> Sherwood 8071 N Lander Avenue / <br /> PO Box 937 <br /> Hilmar, California 95324 <br /> Labs (209) 667-5258 Attention �� Phone� Pae of <br /> C 0 R P O R A T r 0 N FAX (209) 667-2581 -� 7 r -y7 9 —/ -� <br /> Job Number PO # Prot Name <br /> Samplers (Signature) Site Address <br /> IN <br /> SAMPLE LOCATION DATE TIME NUMBER TYPE SAMPLE O�0 act <br /> (IDENTIFICATION) (MTH/DAY/YR) (HOUR/MIN) OF (GRAB MATRIX �� '�� Q'r }�� <br /> CONTAINERS COMPOSITE) r � REMARKS <br /> r0 ° V <br /> — <br /> r - bo r tf <br /> J <br /> 3 i t! V <br /> Relinquished By (Signature) Date/Tme Receiv By (Signature) Date/Time <br /> (�--� .S� TURNAROUND TIME <br /> Relinquished By (Signature) Date(rime Received By (Signature) DatefFiime 24 HOUR ❑ <br /> 48 HOUR ❑ <br /> Relinquished By (Signature) DateRme Received By (Signature) DateiTime 5 DAYI� <br /> f <br /> DISTRIBUTION Original Accompanies SNpment 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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