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ARCHIVED REPORTS XR0011229
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 XR0011229
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Entry Properties
Last modified
3/4/2019 10:20:20 PM
Creation date
3/4/2019 4:43:47 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0011229
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
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WNg
Tags
EHD - Public
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eaea� 11111111111111110 tttttttti ttttttttl■ ttttttttl• tf� i• <br /> 0 Advanced CHAIN OF CUSTODACORD <br /> � <br /> GeoEnvironmental, Inc. Date �° G page `2- of �Z <br /> 837 Shaw Road Stockton, California- 95215- (209)467 1006- Fax (209)467-1118 <br /> ClientP Manager �f J <br /> Tests Required � <br /> Ph9ne Number <br /> Z6e- -(ak <br /> Sa ers (S nature) Invotc <br /> Prolect Name �/��" /' G <br /> AGE r <br /> Cl <br /> Sample Location Sample TypeSolidof <br /> Number Description Date Time Water Air Solid Conts `- Notes <br /> I Comp Grab <br /> { <br /> Rel' ups a ign r Received by ignature atelTime <br /> 1CQ�U <br /> RhLuiquIshed by re) Received by (Signature) DatelTlme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatelTrme <br /> Dispatched by (Signature) DatelTrme Received for Laboratory by r DatelTime <br /> Method of Shipment _ f� laboratory-Name <br /> Special Instructions v f. I hereby authorize the performance o the above Indicated work <br /> I <br />
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