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ARCHIVED REPORTS_XR0002990
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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1612
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3500 - Local Oversight Program
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PR0545246
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ARCHIVED REPORTS_XR0002990
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Entry Properties
Last modified
1/30/2020 8:52:45 PM
Creation date
1/30/2020 3:12:34 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002990
RECORD_ID
PR0545246
PE
3528
FACILITY_ID
FA0003611
FACILITY_NAME
PARKWOODS GAS & FOOD
STREET_NUMBER
1612
Direction
W
STREET_NAME
HAMMER
STREET_TYPE
LN
City
STOCKTON
Zip
95209
APN
07728002
CURRENT_STATUS
02
SITE_LOCATION
1612 W HAMMER LN
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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Nega�af� <br /> bp Chain of Custody Record 03,-site Time: � <br /> Y.: Project Name StatPon No. 548 <br /> v s BP BU/GEM C Portfolio: Allantfc Richfield Company y Site Time: fie,,, <br /> ky Conditions: U L� /n <br /> $P Laboratory Contract Number: Jlztcorologicaf Events: Al Br <br /> Date: () Requested Date Date: Z irk. <br /> T'- A.r Vl+ind Spud: A11_1 Direction: NIA <br /> Send To: BFIGU-1 Facile Na.: 54$ <br /> Lab Name: S uoia-Petaluma ansatlantlConlraclor: C1R5 Co <br /> BP'GEM Facility address: 1612 Ll', Flanimar Lank Slocktan 1[ldrress: 2670 Gafewa Ooks Dr.,5ta 3 <br /> Lab Address: 1455 N.McDowell Blvd, Site ID No, ARCO 543 <br /> Suite D Sacramento,CA 95873 <br /> itaLatlLon : mail EDF----No EDF <br /> Petaluma C,`t 93954 atifornia Gfohal]D.a: T0607700134 vstsaltenl Pro'ecl No.: 38466082.D0327 <br /> Lab PAL- An elecCari MEhI PM Contact: Pact Su la <br /> TeklFax. 707-792.75271707-792.0342ons"t[antTcic/Fax:916-679-20001679-2900 <br /> address: P.O.Box 6548 ans[[Ilant Ph1: Vernon Elarth-916,679.2299 <br /> Re ori Type& Lceal: Leval I Arora a,CA 94570 <br /> BPiGE\v1 Account No.. Invoice to, BPIGT.:Nl <br /> faluFax: 925.799.6891 1;25-299BPIQE\•1 Lvork Rzleaaa No; <br /> Lab 13onle Orxter No; Matrix Prraeavatires <br /> Tteqursted Analysis <br /> v= G <br /> Item � <br /> Sampte tlescripiion � h"a n e <br /> No. � � � Lalroruurl No. � � ' � O° � Snenple P01111 LaIlLongund <br /> Conunenis <br /> o 8 5 0 Q w w <br /> v� d ci cx `fir z U t ate <br /> ] <br /> z fNF Cal AirUfa S X l X Y X <br /> 3 EFF Air <br /> 4 <br /> S <br /> 6 <br /> 7 <br /> 8 , <br /> 9 <br /> 10 <br /> Sampler's Name_ George Bradshaw Retinquishsd 03,1 Afflfi-rtinn <br /> Sam 1Ns Com v: URS Ca ration ��. nee me ccepted DJ 7.11r11at[un ateLme <br /> Shipment,Date: (174r–TA-4 <br /> t i j of <br /> She rnent Method. <br /> Shipment Trackin No: a <br /> S edolInslrucllons: <br /> Cuslody Seals in Place Yes No Temperature Blank Yes No Cooler Temperature on Receipt N °FIC <br /> Dislribution: White Ca Trip Blank Yes No <br /> Copy-Laboratory/Yeltoiv Copy-BPIGEiL•i 1 Pint:Cap, 'nsullanUCantrac lar <br /> EP COC Rev.1 1Isre <br />
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