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ARCHIVED REPORTS_XR0002055
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_XR0002055
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Entry Properties
Last modified
1/30/2020 3:14:19 PM
Creation date
1/30/2020 10:54:13 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002055
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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U w Inc. 1 BEAM <br /> CHAIN OF CUSTODY REPORT <br /> ur!ramr <br /> Beaoon Station No Sarriql6ilPrint Name) Date Form No.t <br /> / L�1 r � }� 1� ANALYSE=S s of <br /> � � <br /> Project No Sa r(Signature) <br /> 124 <br /> Project Location Affiliation -- N <br /> 12 8 <br /> Sc.lc�-av x aleo <br /> ° <br /> Sarrole NoAdentification Date Time Lab No Co zREMARKS <br /> W-os-2 _ 5-2q-gj lv:Yo -- 0 / 1 M <br /> Y ( <br /> R (Signature/Affiliation)S Date Time <br /> li shed by (Sign to Affd tion} Date Time Received b <br /> 1 <br /> Relinquished by (Sig nature/Affiliation) D to Time Received by (Signature/Af filiation) Date Time <br /> Relinquished by (Signature/Affiliation) Date Time Recei by (Signatu e/Affiliation) Date Time <br /> Bill ULTRA R INC <br /> Report To 525 West Third Street <br /> Hanford,CA 93230 �-tl�t O <br /> Attention* <br /> WHITE Return to Client with Report YELLOW Laboratory Copy PINK.Originator Copy <br />
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