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ARCHIVED REPORTS XR0011221
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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F
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FREMONT
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2185
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3500 - Local Oversight Program
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PR0544922
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ARCHIVED REPORTS XR0011221
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Entry Properties
Last modified
10/7/2019 3:35:06 PM
Creation date
10/7/2019 3:18:03 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0011221
RECORD_ID
PR0544922
PE
3528
FACILITY_ID
FA0003284
FACILITY_NAME
FOOD MART GASOLINE*
STREET_NUMBER
2185
Direction
E
STREET_NAME
FREMONT
STREET_TYPE
ST
City
STOCKTON
Zip
95205
APN
14113045
CURRENT_STATUS
02
SITE_LOCATION
2185 E FREMONT ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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SJGOV\wng
Tags
EHD - Public
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-�, uitra&r Inc. BEAN <br /> CHAIN OF CUSTODY REPORT <br /> unramar , <br /> Beacon Station No. Sampler(Print Name) Date Form No. <br /> ANALYSES -Z3-iv of <br /> / rli/rJ U <br /> Project No. Sampler(Signature) <br /> 0 <br /> Project Location, Affiliation c ^ c <br /> Z 1 ��"Er, r��r/7OnT' ,�7�. 0 u�i C <br /> LU __ sfgh-74 � >�� T <br /> Sample No./Identification Date Time Lab No. m a z° REMARKS <br /> i <br /> 0A)"3 -Zz-94 OROS— 3 l�.y,/ vo.95 lfcc Rrs✓ <br /> Relinquished by: (Signature) ffil' ion} Date TimeReceive ; Si atm i io - Date Time <br /> U9¢ <br /> Reh ib gn D to Time e3 b . ( /Affi' i e Time <br /> e i q i h y: ignatur iati n) Date Time Receive aturelAffilialion) e Time <br /> f�c5,-r- <br /> Repo Bi ULTRA NC. <br /> 525 Wes Third Street <br /> Hanford, CA 93230 <br /> A0WV Attention: 1l. <br /> WHITE: Return to Client with Report YELLOW: Laboratory Copy PINK: Originator Copy 3260031M <br />
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