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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
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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tamw .Inc. <br />' �c <br /> CHAIN OF CUSTODY REPORT s ON <br /> Beacon Station No Sampler(Print Name) ANALYSES Io ZT 44 Form f 6 <br /> 4141 AlArk So�.very i ie <br /> Project No. Samp r(Sp ture) <br /> MI. !4 4 � <br /> Project Location 144w. %,w L-aK e, Affiliationq 9Y <br /> Sfeekf6K U,ifhta Nori7ton 6I%V rohw►e4%f0.1 fine-. <br /> Sa No entification Date Time Lab No z REMARKS <br /> 540 - mat _ z� <br /> Sys'-Mktg <br /> S So -M4oJf -q4 <br /> Reb Ished b :(Signature/Af li i } Date Time Received by (Signature/Affiliation) Date Time <br /> orr z oh <br /> Relinquished by:(Signature/Aff bon) Date Time Received by (Signature/Affil!% --- - - Date Time <br /> ti <br /> Relinquished by(Signature/Affiliation) Date Time Recem by Sign elAffihafion) t Time <br /> IA A <br /> Report To: 3111 ULT MAR INC <br /> 525 West Third Street <br /> Hanford, CA Gq230 1 <br /> tT �� Attention. Jot t <br /> WHITE:Return to Client with Report YELLOW Laboratory Copy PINK.Originator Copy <br /> I <br />
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