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ARCHIVED REPORTS_XR0011436
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_XR0011436
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Entry Properties
Last modified
1/13/2020 5:26:03 PM
Creation date
1/13/2020 4:17:49 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0011436
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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CASTLE ANALYTICAL LABORATORY CHAIN 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 OF <br /> Phone: (209) 384-2930 - Fax: {209) 384-1507 <br /> Customer: U��nC �' R>tIUESFEt] 4NALY55_ ' Method of Shipment: <br /> � . <br /> Address: 1+00 ' �1�. XV >'� L� _i,� a n , �+ Cp' G'UGy'1'1 r kk <br /> L :� a <br /> City/StatelZiP: C• 1 Gr, rj '� ; `'w z <br /> _ �, N Ir � Z Notes: <br /> ; �Phone / FAX: m� o: a, L)Proj # / P.O. #: r i 02�:i t4 d , <br /> Report Attention: irri 6i1LA LU c a a a <br /> Sampler Signature: ii g .NLU <br /> Printed: <br /> Z <br /> E.ab EDA SAMPLE ID DATE TIME DESCRIPTIONILOCATION OBSERVATIONSIREMARKS <br /> Awl 199-31-10 4689i <br /> 46892 } <br /> IN- <br /> 46893 <br /> VUN <br /> 2- VOW <br /> r l' I rh�J 12�� lY <br /> JE <br /> otal number of contains submitted t <br /> g:: tUffd', .... i rfhtB€� 86118 8 H- 161113' Ct r>t1} f1�/NafI]O L/ the laboratory <br /> Ts p <br /> Relinquished by: —ladNote:All special requests(e.g-quick <br /> r r, turn times)must be cleared through <br /> Received by: authorized laboratory personnel. <br /> Retingtiished by: <br /> Received by: <br /> Relinquished by: RESULTS DUE <br /> Received by; VERBAL WRITTEN <br /> L c)0 UW7 fecei t—)e,4 5 ✓amu. 947 <br />
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