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ARCHIVED REPORTS XR0011219
Environmental Health - Public
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EHD Program Facility Records by Street Name
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F
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FREMONT
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2185
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3500 - Local Oversight Program
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PR0544922
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ARCHIVED REPORTS XR0011219
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Entry Properties
Last modified
10/7/2019 3:34:52 PM
Creation date
10/7/2019 3:17:41 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0011219
RECORD_ID
PR0544922
PE
3528
FACILITY_ID
FA0003284
FACILITY_NAME
FOOD MART GASOLINE*
STREET_NUMBER
2185
Direction
E
STREET_NAME
FREMONT
STREET_TYPE
ST
City
STOCKTON
Zip
95205
APN
14113045
CURRENT_STATUS
02
SITE_LOCATION
2185 E FREMONT ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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i <br /> MrA. r Inc. Bet©N <br /> CHAIN OF CUSTODY REPORT <br /> unra nar <br /> Beacon Station No. Sampler(Print Name) Date Form No. <br /> �j C�� ANALYSES 7-+,-Y¢ / of <br /> Project No. Sampler(Signature) <br /> m � <br /> Project LocatignAffiliation m <br /> S t o c k/o.7 C'iA f�fl1✓ lrJ c ca v _v <br /> 17�YO <br /> W Z 2 <br /> Sample No./Identification Date Time Lab No. m z I REMARKS <br /> 7-6 -94 09/O <br /> k 3 90y„/ VQY5, IeL Pry✓. <br /> Relinquished by: (Signature/Af 'liation) Date Time Received by: (Signature/Affiliation) Date Time <br /> l `lct�r� /z ' G? //1/�'!j I.�c J�-`Ig 1445 �`l(/�`HN t!1 � <br /> Relinquished by: (Signature/Af�iiiation) Date Time Received by: Signature/Affiliation) Date Time <br /> --------------- <br /> 4 <br /> Relinquished : (Sig nature/Alf ilial ion) Dale Time Receive y: Signature/Affiliation) Date Time <br /> 7 S" <br /> Report To: r Bill to: LTRAMAR INC. <br /> 525 West Third Street <br /> Hanford, CA 93230 <br /> �rf7� rf?C- Attention: /'. <br /> WHITE: Return to Client with Report YELLOW: Laboratory Copy PINK: Originator Copy soa iroo <br />
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