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ARCHIVED REPORTS_XR0005408
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0545495
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ARCHIVED REPORTS_XR0005408
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Entry Properties
Last modified
3/13/2020 7:25:38 AM
Creation date
3/10/2020 4:41:43 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005408
RECORD_ID
PR0545495
PE
3528
FACILITY_ID
FA0006423
FACILITY_NAME
STOCKTON MOBIL 2
STREET_NUMBER
3440
Direction
E
STREET_NAME
MAIN
STREET_TYPE
ST
City
STOCKTON
Zip
95205
CURRENT_STATUS
02
SITE_LOCATION
3440 E MAIN ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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�i UnXTODY <br /> or Inc. BEA& <br /> CHAIN OF REPORT <br /> Beacon Station No. Sampler(Print Name) Data J F,,pprm No. <br /> ANALYSES �--w - Vof <br />� Y �,7 Y A9 R +I <br /> Project No. Sample at re) LO <br /> Affiliat <br /> Project Location " - to <br /> � � c <br /> Sroc � r �� <br /> Sam le NoAdentification Date Time Lab No. m Z. <br /> ° REMARKS <br /> L/ w - / f 2-/Q <br /> L/ kl/ <br /> Relinq ' h y: (Si re/Affiliation) Date Time Received by:(Signature/Affiliation) Date Time <br /> �gn ure/Afiiliation) Date Time Received by: (Signaturelq�iliatior�-� ---� ate Time <br /> Relinquished by:(Signature/Affiliation) Date Time Receive_d,by:(Signature/Affiliation) j Date Time <br /> Report To: <br /> o Bill to: ULTRAMAR INC. 1 <br /> 'I <br /> 525 West Third Street <br /> Hanford. CA 93230 <br /> Attention: <br /> "'0071°° <br /> WHITE: Return to Client with Report YELLOW: Laboratory Copy PINK:Originator Copy <br /> I <br /> 1. <br />
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