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ARCHIVED REPORTS_XR0002045
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_XR0002045
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Entry Properties
Last modified
1/30/2020 11:59:00 AM
Creation date
1/30/2020 10:49:51 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002045
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
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SJGOV\sballwahn
Tags
EHD - Public
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on <br /> mar Inc. &A00 N <br /> CHAIN OF CUSTODY REPORT <br /> Beacon Station No. ANALYSES Sampler(Print Name) I o ID 27t 4 Form 26 <br /> q marrJ� Soc.�vP�vl?it, s <br /> of <br /> 0 <br /> Project No. Sa r( ign ure) <br /> 1211 <br /> Protect Location qw,t�„�,�,,. Lam, Affiliation C 1 J T <br /> cS�C401 h a �.tt���arhi q Airiz&m Lhvrl'C1+�r►�P.& T4E 1nG, <br /> x o <br /> Samgft NoJidentiliication Date Time Lab No ° REMARKS <br /> 525—A4\4 <br /> eO 530— M\4 <br /> 535-M4 -1 l <br /> Sya - M%j4 -to ! <br /> 5q5-Mkl4 - 2E R <br /> 550 - MW4 _ �2 <br /> 5�5-Mw6 - 23 ! <br /> 55 - M X17 <br /> Rel�h by'(Signature/ fail ion) Date Time Received by (Signature/Affiliation) Date Time <br /> r �r ZO•v� <br /> Relinquished by (Signature/Affiliation) Date Time Received by.(Signature/Affiliation) Date Time <br /> Relinquished by (Signature/Affiliation) Date Time Re"nwedbyL ature/Affiliation) Date Time <br /> 14 <br /> Report To BiMAR INC <br /> 525 West Third Street <br /> �y Hanford, CA 3230 , <br /> / Attention e- � r <br /> WHITE Return to Client with Report YELLOW Laboratory Copy PINK Originator Copy � <br />
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