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ARCHIVED REPORTS XR0010731
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 XR0010731
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Entry Properties
Last modified
3/5/2019 1:29:35 PM
Creation date
3/5/2019 11:00:13 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010731
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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WNg
Tags
EHD - Public
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� � i• i• � � � i � � � � � t! s �■s w■ <br /> CASTLE ANALYTICAL LABORATORY CHAIN OF CUSTODY <br /> Location 2333 Shuttle Drive, Bldg 9081909 Atwater, CA 95301 Certificate No 2480 <br /> Mailing Address 2333 Shuttle Drive Atwater CA 95301 PAGEOF <br /> Phone (209)384-2930 - Fax (209)364-1507 <br /> Customer k. REQUESTED ANALYSES Method of Shipment <br /> Address <br /> m m mLL [Y <br /> City/State/ZIP �' -r7 °' '� L w <br /> rn o n w ¢ Notes <br /> Phone 1 FAX ;t �. ¢ Z <br /> Pro d#IPO # LJ <br /> . G � w � w <br /> J = w m U o O <br /> y a c o r`°- n v o to ? 0 <br /> Report Attention J a ¢ K = a m o, <br /> 0 <br /> Sampler Signature 2 g �' Lu <br /> � r w <br /> m <br /> Printed <br /> 2(nA\v5AG-05 5 e o z <br /> w <br /> Lab=ID# SAMPLE ID DATE TIME DESCRIPTION/LOCATION <br /> OBSERVATIONSIREMARKS <br /> Qr It�tu-►6��� <br /> 4.22p <br /> aSMW Ito <br /> 14 L <br /> Z�- u <br /> _ SM <br /> Mk <br /> � _ K <br /> �Sz <br /> 3 <br /> Total number of containers submitted to <br /> SI nature Printed Name Date Time Com an Name the laboratory <br /> Relinquished by 3 r ) L - e , Note All special requests(e g <br /> Received b U <br /> /quick turn times)must be cleared <br /> -711 through authorized laboratory <br /> JRelinquished b personnel <br /> ell <br /> Received by <br /> Relinquished byRESULTS DUE <br /> Received by VERBAL WRITTEN <br />
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