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EHD Program Facility Records by Street Name
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FREMONT
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4100
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3500 - Local Oversight Program
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PR0545177
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Entry Properties
Last modified
1/13/2020 5:34:26 PM
Creation date
1/13/2020 4:05:29 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
WORK PLANS
RECORD_ID
PR0545177
PE
3528
FACILITY_ID
FA0002123
FACILITY_NAME
GREWALS GAS & LIQUOR*
STREET_NUMBER
4100
Direction
E
STREET_NAME
FREMONT
STREET_TYPE
ST
City
STOCKTON
Zip
95215
APN
14333046
CURRENT_STATUS
02
SITE_LOCATION
4100 E FREMONT ST
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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r r <br /> t Advanced CHAIN OF GUSTODY RECORD <br /> CeoEryu�onm tai, Inc. DMI '� Pale <br /> 837 Shaw Road:-Stockton, C&NOrnia-48215-(209)467.1006-Fax(209)467-1118 <br /> Client �`� P� m Tens <br /> 1 ° � R8Ct1ir9(� <br /> R , N or <br /> .67 <br /> (Signature) Involm: <br /> Project Name AGEcom <br /> Satrtpie Type <br /> Sample Location Date TetteWater Solid No.of Notes <br /> Number Description Comp. Grab. Air Conts. <br /> I LI 3 <br /> "A x XX <br /> M <br /> N, <br /> .rgnaturs Receivedy: �rgne4elrlm <br /> Retinqutshed b ignature �f Received by:44ignature) Daleftikw <br /> Relinquished by.(S natural Received by Mobile Laboratory for field analysis:( ) ;" Datef rime <br /> " TA <br /> Dispatched by: (tiignatun) Dauffirns Received tot UWbotatory by: DateRime <br /> Method of Shipment; Laboratory Name <br /> Ct�- ( __,� e +► C� <br /> Special InstructiaroXN, �� 1 hereby authorize the performance of the above Indicated work. <br /> �� t <br />
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