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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
Scanner
WNg
Tags
EHD - Public
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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 PAGE_ OF <br /> Phone (209)384-2930 - Fax (209)384-1507 <br /> Customer ` r 110... �y REQUESTED ANALYSES Method of Shipment <br /> Address ' � Y # � <br /> CM x -1; �, Z <br /> City/State/ZIP Notes <br /> Phone 1 FAX ~ ° `� ~ <br /> .,- o <br /> w 4 w a <br /> Prod#/ P 0 # Wp d <br /> w 4 0. CO � <br /> Report Attention a O 4 X a o Co N o <br /> Sampler Signature 8 " ,- 2 m <br /> Printed 3— t, o _ z <br /> Lab lD# SAMPLE ID DATE TIME DESCRIPTION/LOCATION w OBSERVATIONWREMARKS <br /> 164 'I a 'A 7 <br /> j e, d- S <br /> - ) B,* 41ZAD w etre k Co. iYW <br /> MAO W <br /> h s <br /> Total number of containers submitted to <br /> SI nature Printed Name Date Time Coat an Nam e the laboratory <br /> Relinquished by e� pr}f Gs i ote All special requests(e g <br /> Received by lip -,- quick turn times) must be cleared <br /> b through authorized laboratory <br /> Relinquished <br /> 0 � G personnel <br /> Received by "� <br /> Relinquished by RESULTS DUE <br /> Received by VERBAL Ij WRITTE! <br />
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