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ARCHIVED REPORTS_XR0008861
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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WATERLOO
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2358
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2900 - Site Mitigation Program
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PR0543607
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ARCHIVED REPORTS_XR0008861
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Entry Properties
Last modified
10/10/2020 10:37:33 PM
Creation date
7/9/2020 10:19:38 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008861
RECORD_ID
PR0543607
PE
3528
FACILITY_ID
FA0006343
FACILITY_NAME
STOCKTON MOBIL 3*
STREET_NUMBER
2358
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95205
APN
14118221
CURRENT_STATUS
02
SITE_LOCATION
2358 E WATERLOO RD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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Ultramar Inc. BEACON <br /> CHAIN OF CUSTODY REPORT / 0 I y? <br /> u�rrrnar <br /> Beacon Station No Sampler(Print Name) Date Form No 1 <br /> ANALYSES b-1 - 9 of 1 <br />� y � ev t o C. � �or <br /> Project No Sampler(Signature) nOr,ma� <br /> Project Location Affiliation 'E <br /> N N C <br /> �O G r1 6 E r O r'rltn 4 �►v <br /> _ = rzo <br /> Sample Noildeffi ication Date Time Lab No a REMARKS <br /> \N bbd - T- � - 1L-Cn 10' o6 ---o/ Ia <br /> W - oblb - SFT 0, —d X <br /> Relinquished by (Signature/Affilialion) Date Time R tion) 71 e <br /> Z ��� <br /> Relinquished by (Sqnatu Affliation) Date Time Received Mate Time <br /> Reis ( gnatur (Affiliation) PVeTime Rece by (Stgnature/Affdiation) D to Time <br /> ;In <br /> �Azfl <br /> Repoif To Bill to ULTRAMAR IN <br /> 525 West Third treet <br /> Hanford, CA 93230 1, <br /> • Attention C►�.t� e. r ne. <br /> WHITE Return to Client with Report YELLOW Laboratory Copy PINK Originator Copy 3280031190 <br />
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