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ARCHIVED REPORTS XR0010692
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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749
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3500 - Local Oversight Program
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PR0544218
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ARCHIVED REPORTS XR0010692
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Entry Properties
Last modified
3/5/2019 11:44:43 AM
Creation date
3/5/2019 10:47:45 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010692
RECORD_ID
PR0544218
PE
3526
FACILITY_ID
FA0003870
FACILITY_NAME
SRH FOOD & GAS
STREET_NUMBER
749
Direction
E
STREET_NAME
DR MARTIN LUTHER KING JR
STREET_TYPE
BLVD
City
STOCKTON
Zip
95206
APN
14734309
CURRENT_STATUS
02
SITE_LOCATION
749 E DR MARTIN LUTHER KING JR BLVD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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Tags
EHD - Public
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Bill <br /> AIN OF CUSTODY RECORD14 <br /> 8071 N Lander Avenue <br /> Sherwood <br /> s <br /> �t P O Box 937 <br /> [] Hilmar, California 95324 <br /> Labs (209) 667-5258 Attention_r Phone <br /> C O R P O R A T I O N FAX (209) 667-2581 -,l [%_y� ;� SL7 /za Rage / of <br /> JobNumber P 0 # Protect Name <br /> Samprs (Signature) Site Address Gj cL <br /> �-- r��,s V 3\74 19 IJA il W <br /> CV <br /> SAMPLE LOCATIONDATE TIME NUMBER TYPE SAMPLE C?�y <br /> (IDENTIFICATION) (MTHIDAYlYR) (HOURIMIN) OF (GRAB OR A� ,Z. <br /> CONTAINERS COMPOSITE) MATRIX Q A` tZ/ REMARKS <br /> 0 3 ^ <br /> ys J J <br /> �s ✓ <br /> / <br /> l3 ,sem ✓ ✓ ✓ <br /> k <br /> Relinquished By (Signature) Dale/Time Rec ived By (Signature) Date/Time TURNAROUND TIME <br /> /s/,z <br /> Rehn unshW <br /> (Srgnatur Datefrime ,�.n ecery d By (Signature) DateMme f 24 HOUR ❑ <br /> a ' L0 48 HOUR ❑ <br /> elmquished By (Signature) Date/Time Received By (Signature) Dato[Time 5 DAY @— <br /> DISTRIBUTION Original Accompanies Shipment Canary Copy Sherwood Pink Copy Sampler NOTE Samples are discarded 30 days alter results are reported unless other arrangements are made <br />
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