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ARCHIVED REPORTS XR0009151
Environmental Health - Public
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EHD Program Facility Records by Street Name
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EL DORADO
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3147
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3500 - Local Oversight Program
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PR0544705
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ARCHIVED REPORTS XR0009151
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Entry Properties
Last modified
7/29/2019 11:07:07 AM
Creation date
7/29/2019 10:54:17 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0009151
RECORD_ID
PR0544705
PE
3526
FACILITY_ID
FA0003754
FACILITY_NAME
CALIFORNIA FUELS
STREET_NUMBER
3147
Direction
S
STREET_NAME
EL DORADO
STREET_TYPE
ST
City
STOCKTON
Zip
95206
APN
17512003
CURRENT_STATUS
02
SITE_LOCATION
3147 S EL DORADO ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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i <br /> TL ANALYTICAL LABORATORY CHAIN OF CUSTODY <br /> CASTLE ANA � <br /> Location 2333 Shuttle Drive, Bldg 9081909, Atwater, CA 95301 Certificate No 2079 f <br /> Mailing Address 2333 Shuttle Drive, Atwater, CA 95301 PAGE (f OF <br /> Phone (209) 384-2930 - Fax (209) 384--1"507 <br /> Customer �/'lt y}L'� G+r1 -roi yllw .LIT REQUESTED ANALYSES Method of Shipment <br /> Address ��� a�'th t 15on 1.1�G 1! 2 2 J <br /> City/State/ZIP � j p ' o t o 0 Notes <br /> Phone 1 PAX ( C ) 446-7—1 01101 W 'a s c, U) m <br /> Pro) # 1 P 0 # co C VIC, `} N a 9 a- ri x ;/1 'O o �Sfi t'1 <br /> Report Attention -Z LU w <br /> Sampler Signature 8 <br /> Printed " � z <br /> Lab IRS' SAMPLE IA DATE TIME DESCRIPTIONILOCATION OBSERVATIONS/REMARKS <br /> 1 S ! IZ q,?o S <br /> NWO-511q5- 0 C) S <br /> 1 1 14+1 1 <br /> Total number of containers submitted to <br /> lgnature Printed Name Date Time Company Name the laboratory <br /> Relinquished b=ya. }^ ,Q,- Z -7 -S Note All special requests(e g quick <br /> _U Jturn times)must be cleared through <br /> Received by authorized laboratory personnel <br /> Relinquished by <br /> Received by <br /> Relinquished by RESULTS DUE <br /> VERBAL WRITTEN <br /> Received by \ 1 <br /> 1-Nl l t1 L-`1 1 4 e'3 LJ12. / Z� bC— <br />
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