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ARCHIVED REPORTS_XR0002021
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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H
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HAMMER
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1210
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3500 - Local Oversight Program
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PR0545245
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ARCHIVED REPORTS_XR0002021
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Entry Properties
Last modified
1/30/2020 11:38:26 AM
Creation date
1/30/2020 10:37:43 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002021
RECORD_ID
PR0545245
PE
3528
FACILITY_ID
FA0003730
FACILITY_NAME
TIWANA GAS & FOOD
STREET_NUMBER
1210
Direction
E
STREET_NAME
HAMMER
STREET_TYPE
LN
City
STOCKTON
Zip
95210
APN
09403012
CURRENT_STATUS
02
SITE_LOCATION
1210 E HAMMER LN
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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2795 2nd Street, Suite 300 <br /> AT/FF Davis,CA 95616 <br /> ANALYTICAL LLC Lab: 530.267.4800 �L�a <br /> Project Contact(Hardcopy or PDF to): FAYqf1 997 ASM _ J <br /> Lab No. Page � of <br /> R.Smith EDF Report? ®Yes ❑Na .n <br /> (Company/Address: Recommended but not mandatory to complete this sectlon: Chain-of-Custody Record and Analysis Request <br /> HORIZON Sampling Company Log Code: pEIO �. <br /> Rhone No.: FAX No.: Global ID: Analysis Request <br /> 939-2170 939-2172 T0607700492 _ <br /> m X <br /> ' m 0ject NumberC ProDeliverable (Email Address) <br /> u,11D <br /> 3641 Stockton 3641-op rsmith@horizonenvironmental.net v m a <br /> Pro ect Name: Beacon 2 U1 r x <br /> F } Project Address: ra P P co <br /> Stockton "' � <br /> W -- a <br /> +h W m C W .1. p <br /> Sampler Signature(below}; m z = N v a W � <br /> s: Sam innContain'-sr- <br /> _ _ _ <br /> /f iP 9 a Container Preservative Matriac m o ° r J <br /> Y� /��/J � <br /> E w T2wzozw <br /> xcmle Desi nation Date Tftne v r1n = a a 0- 0 0 0 0 m a 10 m <br /> m ti h r• 1 w <br /> F-29-0 10; <br /> Mw- Y <br /> 123 <br /> 9 w _ 5 <br /> w - 6 0r -o <br /> U/ <br /> /tit w <br /> 1:3 <br /> Relinquished by-. Date <br /> Time Received by: <br /> Remarks: <br /> G'�DvS !I/y <br /> Reiinqui Tamp Mc "ern. IDS ( y <br /> Gate Time Received by Inldalblie` aha:$ Get CM <br /> �— --------- ,._._ TMns W—tr Covient present. t <br /> Relinquished by: O�Data Time Re ived by aboratory: CA <br /> + PIA I V�r 1 BIII to: <br /> Ois;rrbrAfon: lNh/te_Lab, Yellow-Fele,Pink Originator ! <br /> Formslcoc 121001.fh9 <br />
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