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ARCHIVED REPORTS_XR0005409
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3500 - Local Oversight Program
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PR0545495
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ARCHIVED REPORTS_XR0005409
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Entry Properties
Last modified
9/24/2020 12:21:09 AM
Creation date
3/10/2020 4:42:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005409
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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ufframar Inc. BEAC <br /> CHAIN OF CUDDY REPORT <br /> I Zf V-3 <br /> Beacon Station No. Sampler(Print Name) Date Form No. <br /> ANALYSES —30 ! of <br /> Project No. Sample r w <br /> '' 09A,�0412P <br /> 12A <br /> Project Location ;i <br /> 1 Affiliation _ <br /> � o 0 <br /> Sam to Noildentification Date Time Lab No. I lz°I REMARKS <br /> C) r a y <br /> • to <br /> I <br /> 4/1 <br /> w tis <br /> wA T- <br /> � • r � - o� <br /> IJRefinquis i n !filiation) Date Time Received :( ignature/A diation) Date Time <br /> V <br /> R i nature/Affi iation) Date Time Received by:(Signature/Affiliation) Date Time <br /> Relinquished by: (Signature/Affiliation) Date Time Received by:(Signature]Affiliation) Date Time <br /> Report To: q <br /> Bill to: ULTRAMAR INC. <br /> 525 West Third Street <br /> Hanford,CA 93230 r <br /> �r-/' Attention: G } L 2 I Ddb <br /> WHITE. Return to Client with Report YE LOW: Laboratory Copy PINK:Originator Copy a oas�Ao <br />
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