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ARCHIVED REPORTS_XR0002058
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_XR0002058
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Entry Properties
Last modified
1/30/2020 3:30:20 PM
Creation date
1/30/2020 10:55:21 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002058
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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U or Inc BE ON <br /> uah+ne�■r <br /> CHAIN OF CUSTODY REPORT <br /> Beacon Station No. Sar(Prim Name Date Form No <br /> &Iq I� ANALYSES /of Z-- <br /> i <br /> Project No <br /> La <br /> Project Location, 44 1tAffjno0P'- <br /> , � <br /> Sample NoJldentlfecalbn 7 Date Time Lab No zi REMARKS <br /> - -: _ z_ <br /> -S' <br /> _S -z.� - Z- Po <br /> L <br /> .S- - I <br /> Rel ish •(Signal AffiElab Date Time 1 Received by (Signature/A)fihation) Date Time <br /> ReAumfied y nature/Atfi tion) a Time Rece ved by (Signature/Affiliationi Dae Time' <br /> Relinquished by (Signature/Affiliation) Date Time Received by (Signature/Affiliation) Date Time <br /> Report To�� Bill to ULTRAMAR INC <br /> y y '� 525 West Third Street <br /> / Hanford,CA 93230 -14 <br /> 9 39- ,71 Attention <br /> WHITE Return to Client with Report YELLOW Laboratory Copy PINK Originator Copy �+ � <br />
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