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ARCHIVED REPORTS_XR0002022
Environmental Health - Public
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EHD Program Facility Records by Street Name
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H
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HAMMER
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1210
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3500 - Local Oversight Program
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PR0545245
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ARCHIVED REPORTS_XR0002022
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Entry Properties
Last modified
1/30/2020 12:00:19 PM
Creation date
1/30/2020 10:38:13 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002022
RECORD_ID
PR0545245
PE
3528
FACILITY_ID
FA0003730
FACILITY_NAME
TIWANA GAS & FOOD
STREET_NUMBER
1210
Direction
E
STREET_NAME
HAMMER
STREET_TYPE
LN
City
STOCKTON
Zip
95210
APN
09403012
CURRENT_STATUS
02
SITE_LOCATION
1210 E HAMMER LN
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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2795 2nd Street, Suite 300 <br /> TtANALMCAI. <br /> � Davis,CA 95616Lab: 530.297,4800 LLC Fax: 530.297.4808 Lab No. d I Page of ` <br /> Project cAh It�r�Py or PDF To): California EDF Report? PCYes ❑No <br /> Chain-of-Custody Record and Analysis Request. <br /> Company ddress: Ra=...wd9dhutnot b elhlssadiw� � <br /> [Sampling Company Log Code: <br /> � f � Analysis Request � <br /> Phone No.: FAX N • Global ID: m Y <br /> a 6 �• d $ cc a w <br /> Project Number: P.O. No: iEDt= five le To(f all d SCc, w <br /> m a, <br /> m � o <br /> Proj//e��cyyt��N/a��m��e: ff Sampldr Signature: ,r.t�, S S _ �n m m <br /> a w m m CG 'S w r N <br /> C7 NEll <br /> Project Address: a a N °� n J N ro <br /> Sampling Can n r Pre ervative Matrix N _ a 1 �_ � �, N ; ,; t .J <br /> f�//__ ¢ m 9 r _a 2 m LL- L v <br /> 0 W M U. <br /> w `Y 7�x( �xx N �I m m N <br /> W il.� <br /> uJ = x Y 0 0 0 a 0 t <br /> E O z t- x v <br /> Sample Desi nation Date Time v Cnn 1 = 2 v z rOn m m ti A � <br /> i o �1 p _0l <br /> le )c _6L <br /> Relinquished by: r" + C f Da Time Received by: Remarks: e <br /> 1 'f IV105 I If$ <br /> Reli quished yData <br /> bre <br /> Relinquished by: Dale Time Received by Laboratory: vol Bill to: �a <br /> Qlstribufian%a?•;e-Lab, Pirtle-Originator ''ti:i' � � slcoC 127001.1h9 <br />
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