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ARCHIVED REPORTS_XR0002058
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_XR0002058
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Entry Properties
Last modified
1/30/2020 3:30:20 PM
Creation date
1/30/2020 10:55:21 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002058
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 I_� I- � � � � tftftftftfi tttttttttt� � - <br /> Ultramar Inc. BEACON <br /> CHAIN OF CUSTODY REPORT l ve? 3 <br /> Beacon Station No Sampl r(Pant Nam /J Date Form No <br /> 64( <br /> M4 • +� ANALYSES 9-17-97 of <br /> Project No Sa pier(S ature) ik 41 Ale <br /> Project Location Affiliat n = 0 <br /> �r <br /> rn o 0 <br /> w = = <br /> Sam le NoAdentification Date Time Lab No m � 19 z° REMARKS <br /> 710 - MWS 17-97 0919 ' - 0/ &1 1 1 I <br /> mWS o¢�L { <br /> S --3c7- MCI, °Z !r <br /> aJ P J <br /> 0 91 0 <br /> 3 <br /> S -MWS 090 6 <br /> S -SS —/V&/S I <br /> Relinquish by (Signa a/Affiiiat�on) Vafe <br /> Date Time Received by (S�gnature/Affil�at�on) Date Time <br /> le-�- <br /> 'Relinqdished (Signature/Affiliation) Time Received by (o gnature/Affiliation) /bafeTime <br /> Relinquished by (Sig naturet ffiliatio ) Date Time Received by (Signature/Affiliation) Date Time <br /> Report o Bill to ULTRAMAR INC <br /> 525 West Third Street <br /> Hanford, CA 93230 <br /> x fla —�39 �u7L Attention /, <br /> WHITE Return to Client with Report YELLOW Laboratory Copy PINK Originator Copy uaooziaio <br />
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