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ARCHIVED REPORTS_XR0002033
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_XR0002033
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Entry Properties
Last modified
1/30/2020 3:16:51 PM
Creation date
1/30/2020 10:43:31 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002033
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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i • � . <br /> 2795 2nd Street, Suite 300 <br /> .�� Davis,CA 95616 <br /> Lab 530 297 4800 <br /> ANALYTICAL LLC F:nv Rn �n 907 Bann Lab No ` J � Page-Zof <br /> Protect Contact(Hardcopy or PDF to) EDF Report? ®Yes No 0 <br /> R Smith Chain-of-Custody Record and Analysis Request <br /> Company/Address Recommended but not mandatory to complete this section — <br /> HORIZON Sampling Company Log Code DEIO Analysis Request F <br /> Phone No FAX No Global ID 70607700492 X <br /> 939-2170 939-2172 mo mo n r <br /> oto to m w <br /> Protect Number PO No EDF Deliverable to(Email Address) c m m in o T <br /> 3641 Stockton 3641-29 rsmith@honxonerrvironmentat net - m u� w m x OC <br /> Protect Name Beacon Project Address � m to �- a d <br /> Stockton win �; �; a 0 a -� gN <br /> S G e Ibelowl 00 1 x x " r4 U o ^ a <br /> Sampling Container Preservative Matrix N - o k P P m2 n, C4 0 <br /> f° m w `m in 0 0) r � M m <br /> a ` <br /> i- a N O � 0 01 m m O N � � <br /> 0) O to m <br /> > M L!J LUm F ^ 10 rn cm <br /> 0 rn to N w N <br /> E h- X m to C} > Q > w = <br /> o w� U zz LU <br /> p Q p w u� x 2 x O O m Q <br /> Sample Designation Date Time a to z = v z m m a w LnJ W J <br /> J Cy - - -- - - ,z <br /> Relinquished by / Date Time Received by Remarks <br /> K 3`2- `Y t,nqu,;hed by Date Time Received by <br /> Relinquished by hate Time Recei d by��oratory 1 Bill to <br /> �� d3 IIs � � <br /> Distribution While Lab Yellow Frio Pink Onginaff r Formslcoc 121001 fh9 <br />
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