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ARCHIVED REPORTS XR0011227
Environmental Health - Public
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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 XR0011227
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Entry Properties
Last modified
3/4/2019 11:56:39 PM
Creation date
3/4/2019 4:43:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0011227
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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� I• � � � � � � � Ii r I� � IIIIIIIIII� r• � � <br /> CHAIN OF CUSTOD*ECORD <br /> Advanced <br /> Date 71� PEW _.� of �-_ <br /> --- GeoEnvironmental, Inc. <br /> 837 Shaw Road-Stockton, California-95215- (209) 467-1006- Fax (209)467-1118 <br /> Client r^�. Y� Pr Manager Client �} Tests equired <br /> Lk e <br /> Number (� <br /> Samplers (Signature) Invoice <br /> AGE <br /> Project Name Client ❑ <br /> Sample Location Sample Type <br /> Sam <br /> p Date Time Water Solid No of N Notes <br /> Number Description comp crab Air Cortts <br /> �tw 13 1q� <br /> `14 Y <br /> RA/ I A- <br /> . -3NmM <br /> I Ix .1 <br /> e rnquis e y azure cetva y ignakure <br /> e Da [Time <br /> Z • 4�' <br /> Daterrime <br /> Relinquished by tgnature) Received by (Signature) <br /> Received b Mobile Laboratory for field analysts.(Srgnetwe) S`�� Datal7ime <br /> Ral+nqunshed by (Signature) Y J <br /> Dato/Time ceived for laboratory Date(Tlme <br /> Dispatched by (Signature) - p -� G <br /> Labors Name u <br /> Method of Shipment <br /> t <br /> special instretettona <br /> i hereby authorize the performance of the above indicated work <br /> �\� � C� - � <br />
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