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ARCHIVED REPORTS_XR0002044
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_XR0002044
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Entry Properties
Last modified
1/30/2020 11:57:43 AM
Creation date
1/30/2020 10:49:26 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002044
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 /> V1trear Inc. Ni <br /> CHAIN OF CUSTODY REPORTO <br /> �V <br /> Beacon Station No Sampler(Print Name) Dat Form No <br /> 6-91 `` A N YS/V1��S 1'�5 ' e5 <br /> � 4� 1 AL <br /> Protect No / Sampl i r f'7`fl vt�J/f�fZ_/' <br /> 6:�Ll ! t/1-70— <br /> Project LocationAffiIio <br /> ia n <br /> SrQG � TG � �c�vGo � � c <br /> X —� <br /> Sample NoJldentification Date Time Lab No m pzo tiEMARKS <br /> S -- 6 -6 '00 _'pq <br /> V w <br /> VW - 3 6 :5 <br /> r t l <br /> Vw - 7 -2 - 31 - r <br /> Relinquished by gna re/ ihation) Date Time Received by (Signature/Affiliation) , Date Time <br /> f <br /> poUz �S <br /> RelinquiiKl bf( re/Affihation) Date Time Received by (Signature/Affiliatton) Date Time <br /> Relinquished by (Signature/Affiliation) Date Time Received by (Signature/Affiliation) vi. Date Time <br /> Report To Bill to ULTRAMAR INC <br /> 525 West Third Street <br /> Hanford, CA 93230 <br /> Attention _ <br /> WHITE Return to Client with Report YELLOW Laboratory Copy PINK Originator Copy u'°07A0 <br />
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