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Environmental Health - Public
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EHD Program Facility Records by Street Name
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2210
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3500 - Local Oversight Program
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PR0544594
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Last modified
6/21/2019 4:10:42 PM
Creation date
6/21/2019 2:47:08 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0544594
PE
3528
FACILITY_ID
FA0006298
FACILITY_NAME
DANIELS PROPERTIES
STREET_NUMBER
2210
Direction
W
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12330040
CURRENT_STATUS
02
SITE_LOCATION
2210 W COUNTRY CLUB BLVD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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CASTLE ANALYTICAL LABORATORY 16 Ce � ;3�U, HAIN OF CUSTODY <br /> Location: 2333 Shuttle Drive, Bldg 908/909, Atwater, CA 95301 Certificate No. 2079 <br /> Mailing Address: 2333 Shuttle Drive, Atwater, CA 95301 PAGE_jOFJ <br /> Phone: (209) 384-2930 - Fax: (209) 384-1507 <br /> Customer: Advanced Genif REQUESTED ANALYSES Method of Shipment: <br /> Address: 1400,7 k5nr- 11 .0Lo <br /> „ rn <br /> City/State/ZIP: p , P • _ex O d 6 w ^ <br /> Phone / FAX: _ ILao _ a s a w �_ F Notes: CCl91Gr '���:�� <br /> Proj # / P.O. //: a UJ = a m w °° oz seated <br /> CW a,� -, _c v <br /> Report Attention: � ° " a a. o <br /> Sampler Signature: ii $ y m ~ f- w <br /> Printed: <br /> z <br /> Lab IDX SAMPLE ID DATE TIME DESCRIPTION/LOCATION00 OBSERVATIONS/REMARKS <br /> 1- .3-6-99 0 S <br /> � _ _� ! <br /> ,o <br /> 8.6598_ <br /> 86599 <br /> r , <br /> VOA <br /> MEWSo <br /> G009 GONOM <br /> Total number of containers submitted t <br /> ig tune Printed Name Date Time Company Name the laboratory <br /> Relinquished by: ;f)[} Note:All special requests(e.g.quick <br />` <br /> Received by: 3 r �y.Z turn times)must be cleared through <br /> Relinquished by: authorized laboratory personnel. <br /> Received by: <br /> Relinquished by: RESULTS DUE: <br /> Received by: VERBAL WRITTEN <br />
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