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ARCHIVED REPORTS_XR0007289
Environmental Health - Public
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EHD Program Facility Records by Street Name
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W
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WILSON
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2211
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3500 - Local Oversight Program
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PR0545106
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ARCHIVED REPORTS_XR0007289
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Last modified
12/19/2019 4:22:57 PM
Creation date
12/19/2019 4:05:23 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007289
RECORD_ID
PR0545106
PE
3529
FACILITY_ID
FA0003694
FACILITY_NAME
RIVER CITY PETROLEUM CARDLOCK
STREET_NUMBER
2211
Direction
N
STREET_NAME
WILSON
STREET_TYPE
WAY
City
STOCKTON
Zip
95205
APN
11707050
CURRENT_STATUS
02
SITE_LOCATION
2211 N WILSON WAY
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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AAIN OF CUSTODY RECORD <br /> J Sherwood PO1Box 937 Lander Avenue <br /> U <br /> Hilmar, California 9532 <br /> Ps (209) 667-5258 Attention Phon Page of <br /> C O R P O R A T I O N AX (209) 667-2581 <br /> Job Number PO # Project Name <br /> CO <br /> Sampl ignature) Site Address ::z\ <br /> 4j <br /> v ory <br /> SAMPLE LOCA ON DAT TIME NUMBER TYPE SAMPLE �,- <br /> (IDENTIFICATIO (MTH/DAY/YR) (HOUR/MIN) OF (GRAB OR MATRIX <br /> CONTAINERS COMPOSITE) ro REMARKS <br /> Ivi1-10 1r <br /> z, <br /> A Y� <br /> R ed By (Si ature Datr7410 <br /> 19 !1S ecerved�Byy (Signature) Date/Time h /7 TURNAROUND TIME <br /> lqe <br /> R —,4f Y 011Z <br /> elhn cashed By (Signatur Date me geceive By (Signature) ate/Ti a 24 HOUR ❑ <br /> 48 HOUR <br /> R ingwshed By (Signature) Date/Time Received By ignature) Date/Time 5DAY <br /> DISTRIBUTION Original Accompanies Shipment Canary Copy Sherwood Pink Copy Sampler NOTE Samples are discarded 30 days after results are reported unless other arrangements are made <br />
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