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ARCHIVED REPORTS_XR0011430
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_XR0011430
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Entry Properties
Last modified
1/13/2020 5:30:54 PM
Creation date
1/13/2020 4:16:06 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0011430
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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SJGOV\wng
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EHD - Public
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CASTL ANALYTICAL LABORATORYCHAIN OF CUSTODY <br /> Location: 2333 Shuttle Drive, Bldg 9081909, Atwater, CA 95301 Certificate No. 2079 <br /> Mailing Address. 2333 Shuttle Drive, Atwater, CA 95301 PAGE___,LOF <br /> Phone: (209) 384-2930 - Fax: (209) 384-1507 L� <br /> Customer: Vl �,, REpUS D., LYSE6 --- <br /> Address: A 89354 <br /> City/State/ZIP: o `� 5---- -- - <br /> Phone 1 FAX: ° J <br /> �-� U—j W W <br /> Prod # i P.o. #: C r- .fes a s a 89355 <br /> Report Attention: w x <br /> a <br /> Sampler Signature: a m ~ <br /> Printed: °' - $. 5 <br /> Lab 11)# SAMPLE ID DATE . TIME DESCRIPTIONILOCATION r `` 89357 :1ARKS <br /> ~q r 89358 . <br /> 3W Ad <br /> P-io I 15" l Z <br /> 89359 <br /> 0 V 89360 <br /> a1459361 <br /> WqVr <br /> r -3 89382 <br /> 89363 <br /> —41 <br /> b d <br /> S'gtisture POnted Name Qat. , TPirri .. Cpm ry.'Narn ; 89364 mltte I <br /> Sit D <br /> . _ <br /> Relinquished by: g. quick <br /> Received by: `i - ('. �G, , r � 89365 hrough <br /> Relinquished by: -- <br /> Received by: 89366 <br /> Relinquished by; <br /> r r --- <br /> Relin <br /> q <br /> Received by: <br /> 89367 <br />
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