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ARCHIVED REPORTS_XR0002027
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_XR0002027
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Entry Properties
Last modified
1/30/2020 11:56:37 AM
Creation date
1/30/2020 10:40:48 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002027
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 /> • � <br /> Davis, $1 <br /> Lab 530 2974800 <br /> ANALYTICAL i jrr M_ .___ Lab No 7 Page_J—of <br /> Project Contact(Hardcopy or PDF to) EDF Report? ®yes ❑No No <br /> R Smith Chain-of-Custody Record and Analysis Request <br /> CompanylAddreSS Racomm.nded but not mandato to compute this asctlon _ <br /> HORIZON Sampling Company Log Code DE10 � <br /> Analysis Request <br /> Phone No FAX No Global ID T0607700492 - <br /> 939-2170 939-2172 pp m <br /> O �D !O N W <br /> Project Number PO No G EDF Deliverable to(Email Address) m y °D o <br /> 3641 Stockton 3641-� rsmith@horizonenvironmental net <br /> m o u� x SO x <br /> Project Name Beacon Project Address J G <br /> Stockton in m m Q � <br /> C3 �, m m .c w ° r <br /> Sampler Signature(below) _ <br /> ress _ a� fe am Iang Container Preservative oMatrix <br /> cc _ o <br /> Q m C7 um O <br /> N CD In <br /> 0 , m O w c c ca m ' � = v v U' <br /> C �/✓�/ n <br /> LU tSJ J K x� m W (7 mrn rn o� >W m <br /> E w O z W 1 Ji Z 2 f'c �r x C !a t <br /> • o U Z V O a 0 P r a. a. a o 0 0 m a o o w <br /> S le Designation Date Time v z z _ z rn m m - �, J w > J <br /> I/W_ 'apo 3 oKI -l! <br /> VW— 7 v o: 3 X -/z <br /> Relinquished by irate Time Received by Remarks <br /> Relinquish Date Time Received by <br /> Relinquished by Dale ;Time Rece y Lahore4 Bill to <br /> fl' n 13 F1 f#6 V A A-/ <br /> Durnbubon MAW-Lab Puck-0M01WW Form km 121001 fig <br /> I <br />
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