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ARCHIVED REPORTS_XR0011420
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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4100
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3500 - Local Oversight Program
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PR0545177
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ARCHIVED REPORTS_XR0011420
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Entry Properties
Last modified
1/13/2020 5:27:00 PM
Creation date
1/13/2020 4:13:12 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0011420
RECORD_ID
PR0545177
PE
3528
FACILITY_ID
FA0002123
FACILITY_NAME
GREWALS GAS & LIQUOR*
STREET_NUMBER
4100
Direction
E
STREET_NAME
FREMONT
STREET_TYPE
ST
City
STOCKTON
Zip
95215
APN
14333046
CURRENT_STATUS
02
SITE_LOCATION
4100 E FREMONT ST
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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�r irr r � r r rr irr i�r iii•r irr r ire i�r r irr <br /> CHAIN OF CUSTOD*ECO D <br /> Advanced Date i Z3-o1F Page --L of <br /> GeoEnvironmental, Inc. <br /> ;. -. <br /> 837 Shaw Road- Stockton, California-95215- (209)467-1006- Fax (209)487-1198 <br /> Client Project Manager pp Tests Required <br /> Phone Number <br /> S lens: (Signature) Invoice: <br /> AGEA- <br /> Project Name C'/ > Client ❑ <br /> SanWType No. of Notes <br /> Sample Location Date Time Water Solid <br /> Number Description camp. Grab. Air Cants. <br /> t6-wV i <br /> p.A.t_,z o+L 36 ia• <br /> 1�w OiZ3 <br /> ALJ 3 etz 1 P55 <br /> - e _ Ikk v► had 7 <br /> 4 <br /> I 9ate/Tifile <br /> e r rs a rgnature) eceive y., I nature �-r <br /> � Date ime <br /> rnquished by: (Signature) Received by: (Signature) <br /> Date/Time <br /> nature Received by Mobile Laboratory for field analysis: ature) <br /> Relinquished by: (Sig ) <br /> site/Time <br /> ce' ed t b story D te1Ti e� <br /> Dispatched by: (Signature) <br /> Labor ory N I <br /> r <br /> =Methodofment: Jrt`�j��f <br /> i here authorize the pertthe above Indicated work. <br /> Special instructions, l� <br /> I <br />
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