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ARCHIVED REPORTS XR0011225
Environmental Health - Public
>
EHD Program Facility Records by Street Name
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D
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DR MARTIN LUTHER KING JR
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701
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3500 - Local Oversight Program
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PR0544217
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ARCHIVED REPORTS XR0011225
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Entry Properties
Last modified
3/4/2019 10:04:52 PM
Creation date
3/4/2019 4:42:44 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0011225
RECORD_ID
PR0544217
PE
3526
FACILITY_ID
FA0002512
FACILITY_NAME
GSG GAS & MART
STREET_NUMBER
701
Direction
E
STREET_NAME
DR MARTIN LUTHER KING JR
STREET_TYPE
BLVD
City
STOCKTON
Zip
95206
APN
14734311
CURRENT_STATUS
02
SITE_LOCATION
701 E DR MARTIN LUTHER KING JR BLVD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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CHAIN OF CUSTODRECORC <br /> Advanced <br /> _ Date �(c0iL4 pie � <br /> GeoEnvironmenW, Inc. <br /> 837 Shaw Road-Stockton, California-95215-(209)467-1006- Fax (209)467-1118 r <br /> Client �C t-2c-t, Ci' cam vv �. L=L Pro�ctCk n <br /> ager , Tests Required <br /> Phone N�imb� <br /> Samplers (S �,� ,��Involve <br /> i <br /> 1 � ti" AGS -, <br /> Protect Name �( � —t \ �� Cllm � <br /> C` X f <br /> Sample Location — <br /> Sample Type �`LocationNa of <br /> Number Description Date Time Water Air Solid ContS Nates <br /> Comp Grab <br /> ( acL4r 1`t"� 1 i fit, LK l r iyl x <br /> LL LL- \44 I <br /> <xW A <br /> I "A,:y �J_kt')L �--1 <br /> L , <br /> r ` <br /> x, <br /> e r qua nature ecerva y ignatun DatelC��n4 <br /> L <br /> Relinquish y (Signature) Received by (Signature) Data ime <br /> elrnquished by (Signature) Received by Mobile Laboratory for field analysm (Signature) AFT Dalej-'Me <br /> Dispatched by (Signature) DatelTrme ]Received for Laboratory by ' Data+'Tim <br /> Method of shipment Laborato Name �s <br /> tipac�at laal[uGttons � �, s t. � <br /> 1 he authorize t or rm�ea`of the above indicated urovk <br />
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