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ARCHIVED REPORTS XR0012673
Environmental Health - Public
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EHD Program Facility Records by Street Name
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Y
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YOSEMITE
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1399
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3500 - Local Oversight Program
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PR0543988
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ARCHIVED REPORTS XR0012673
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Entry Properties
Last modified
12/28/2018 11:00:58 AM
Creation date
12/28/2018 10:42:00 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012673
RECORD_ID
PR0543988
PE
3500
FACILITY_ID
FA0000914
FACILITY_NAME
TIGER EXPRESS STORES
STREET_NUMBER
1399
Direction
E
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
CURRENT_STATUS
01
SITE_LOCATION
1399 E YOSEMITE AVE
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
Scanner
TMorelli
Tags
EHD - Public
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ll' <br /> ;L <br /> DELTA Sample IdentiFcatioFi;. —Ad Chani of Cg`s y R ole <br /> ENVIRONMENTA€.CONSULTANTS,INC. j �3 F- — 1�, 1 <br /> Project: _/,?9 i E' W.Q.;x ✓- �b• 1 <br /> Shipped by: (n.��•/.�a r/ - <br /> Shipped to: �> >�••i r-�>i<�X Cc. .r�J. %r�cf Attention of: <br /> Comments: Hazardous materiats suspected?(yesfno) <br /> Sampling <br /> samPoint t-ocation Fo,td 10� Date Type Conveners RequNo.of kod <br /> !A l4�`�. 1 !(9 ttr` Z-y % 5'�' �Cl a-e-c l ! �^t�/tY^�n <br /> i` <br /> j p <br /> Samplar(s)(signature) <br /> Heid ID Relinquished try:(ii[nature) Received by:tstpnawma DateMme comments <br /> i ,r• <br /> Sealed for shipment by:(signature) Date(T•ime �' �l9 l {'�" '^ <br /> Shipment method: rf_/.��•.,,� <br /> Received for Lab by:(signature) 21 !f�f] 75�I1_.�,A,��i�F�_ Data�me,5—2- `1 C=�3J Comments �' 0. r. <br /> Receiving t sboratory:Pleaza return original form a:ta:signing for receipt of samFios. <br /> it a <br />
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