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ARCHIVED REPORTS_XR0002047
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_XR0002047
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Entry Properties
Last modified
1/30/2020 11:38:22 AM
Creation date
1/30/2020 10:51:02 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002047
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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U40nar Inc. a� BEGON u, . <br /> CHAIN OF CUSTODY REPORT �— <br /> Beacon Station No. Sampler(Print Name) Dat Form No <br /> ANALYSES t of <br /> Project No Sample S at re} i v C <br /> Project Location Aff fiat n - h <br /> t !� �D a GO f 4ft �- <br /> a <br /> i ] <br /> Sa le NoAdentifiication Date Time Laz REMARKS <br /> ' = <br /> d4 jv <br /> i <br /> • o� - 03 <br /> w r Y9 rbc <br /> / � 1 <br /> -o7 <br /> tk/- -o <br /> Relinqued y s Affiliation) Date Time Received by (Signature/ diation) Date Time <br /> Ano��� <br /> R y (Signature/Affiliation) Date Time Received by (Signature/Affdiation) Date Time <br /> Relinquished by (Signature/Affiliation) Date Time Received by (Signature/Affiliation) _ Date Time <br /> Report To Bill to ULTRAMAR INC <br /> 525 West Third Street <br /> Hanford,CA 93230 U� <br /> �. 2 �� �, Attention G r61 <br /> y <br /> WHITE. Return to Client with Report YELLOW Laboratory Copy PINK Originator Copy <br />
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