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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0545384
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
3/4/2020 4:39:34 PM
Creation date
3/4/2020 4:17:59 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545384
PE
3528
FACILITY_ID
FA0006295
FACILITY_NAME
HENRY WOLTERS & SON
STREET_NUMBER
888
Direction
E
STREET_NAME
LINDSAY
STREET_TYPE
ST
City
STOCKTON
Zip
95206
CURRENT_STATUS
02
SITE_LOCATION
888 E LINDSAY ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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vnATE WORK <br /> CHAIN-OF-CUSTODY REC J AND ANALYSIS REQUEST <br /> PROJ.NO. PROJECT NAME <br /> ANALYSIS TYPE REQUESTED „ <br /> 263 Sko 6.Q k <br /> SAMPLERS.(Signature) - w <br /> of a <br /> w <br /> I.D.N0. DATE TIME Z CL <br /> STATION&LOCATI0 ccON U <br /> 00 a w REMARKS <br /> s 1 c D <br /> TOO- I �I a <br /> 9:.35• ,. - r+ as � . . <br /> 71 <br /> _-5P2-I k �,. . �.� 1 S _ <br /> rS. <br /> G1P...e S <br /> -------------- <br /> PLEASE RETURN ICE CHES4R- <br /> by. <br /> av <br /> AND BLUE ICE TO WATERWO <br /> LAB PAro C•"R ingufahed by. Date Time Received by: Relinquished by: Date Time Received by:� nURelinquishedby: Date Time Received by: Relinquished by: Date Time. Received <br /> by: Date TimeReceived by Laboratory: Date Time REMARKS(Shipping Related): <br /> K , '31-7 <br /> u <br /> F . <br />
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