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ARCHIVED REPORTS XR0006453
Environmental Health - Public
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EHD Program Facility Records by Street Name
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D
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DOUGLAS
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1807
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3500 - Local Oversight Program
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PR0544622
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ARCHIVED REPORTS XR0006453
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Last modified
7/3/2019 2:47:01 PM
Creation date
7/3/2019 1:59:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006453
RECORD_ID
PR0544622
PE
3528
FACILITY_ID
FA0003905
FACILITY_NAME
PAIGES TOWING
STREET_NUMBER
1807
STREET_NAME
DOUGLAS
STREET_TYPE
RD
City
STOCKTON
Zip
95207
APN
09721019
CURRENT_STATUS
02
SITE_LOCATION
1807 DOUGLAS RD
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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�r rr rr r � r r rr � r r it■■i rr �r r r �■r �■■� rr <br /> CASTLWNALYTICAL LABORATORY <br /> CHAIN OF CUSTOM <br /> Location: 2333 Shuttle Drive, Bldg 9081909, Atwater, CA 95301 Certificate No. 2079 <br /> Mailing Address: 2333 Shuttle Drive, Atwater, CA 95301 PAGEOF__/ <br /> Phone: (209) 384-2930 - Fax: (209) 384-1507 <br /> Customer: 7 !'+7 l REOUESTED ANALYSES Method of Shipment: <br /> Address: a +] �, to r ,jQtU <br /> City/State/ZIP:S- <br /> a o �, Notes: <br /> Phone / FAX: (�` — Lr �j - Jj W <br /> Z <br /> w V uJ o <br /> Proj ff / P.O. #: a W _tr p 0° o a - v <br /> Report Attention: ;., `, 8 a a J n <br /> o <br /> g <br /> Sampler Signature: a S m `� '- In W <br /> Printed: " " f' <br /> Z <br /> Lab 100 SAMPLE ID DATE TIME DESCRIPTIONILOCATION OBSERVATIONS/REMARKS <br /> w- v: 24 <br /> + w /1:00 <br /> 4 <br /> F ` <br /> GOOD CONDITION PPROPRIA <br /> HEAD SPACE ARK 4T-V ONTAINER <br /> Total number of containers submitted to <br /> Si t Ie Printed Name D to Time Company Name the laboratory <br /> Relinquished by: ? ['CS U L7 Note:All special requests(e.g.quick <br /> _� turnlimes)must be cleared through <br /> Received 6y ~' l2 1 L_ A m authorized laboratory personnel. <br /> Relinquished by: <br /> Received by: <br /> Relinquished by: RESULTS DUE : <br /> VERBAL WRITTEN <br /> Received by: VE [ <br />
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