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ARCHIVED REPORTS_XR0003012
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_XR0003012
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Entry Properties
Last modified
1/30/2020 7:58:47 PM
Creation date
1/30/2020 3:33:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003012
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
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SJGOV\sballwahn
Tags
EHD - Public
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SEQUOIA AINALYTXCAL SAWLIC, RECEWr LOG <br /> CI.,IENT-NAME: k:�-' DATE Received at Lab: r'q -r;L-67i Drfnkfng wRter for <br /> RUC.B7((PRS) j °,l'M Tteocived at Lab: j a"q, regulatory Purposes_ X-S 1 <br /> WORXORDIIL- AlI- ',6-PT LOO IN DATE: 4=4-91-OZ,- 'G Ute-sl2terfor <br /> ^ .. _�.....T' regulatory purposes. ' S I PgP <br /> ` CMCLX'biz APPROMII:ATE PXSPO SE LAB CONTAlZS-ER SAM= DATE I jMNzkRxS- <br /> SAMYLE# # CLIENT ID DFSCPJPTTOW MATRLY SA.MPDTGD GQ'VDIITIon C. <br /> X. custody stales) Present! t b5wl•Aq 0"4-PV <br /> Xntnt I Brok=* f <br /> 2. Chain-of Cuslod J Ab:swn- 6F P- Air ✓ <br /> 3. Tr Zo Rgcm or <br /> Pucldn List: F==t I setz <br /> 4. Airbill: • AirbM 1 Sticke <br /> Iareseut 1�sefi[ <br /> 5. AirbilL <br /> 6. Saul Ie l.abCls: z A•bsant . <br /> 7. Sunple Ms Not Listed <br /> on Chain-ofCustnd <br /> S. Sample Condition: Broke*I <br /> 9. Does infb=ation on <br /> eustody reports,lr,,Zc o <br /> reports and 5MMPIC <br /> 1a;7eIs aC? Yes'l�To" ' <br /> 10, S=Ple received widlia " <br /> Hold time: es No* <br /> " 11. �'�per Presex•vati�ves <br /> usod' s V -q* <br /> 12. Temp R.ec.at Lab. � <br /> (Acmptsncc range for samyles <br /> tCC�U1ITII LlllsmaE pres.:4+1-2'lC) YCS 1 VQww <br /> * e contact Fra'ect Mamkgger and attach record of lresotution. <br /> Sarnplo Rocelpt Log <br /> Revlslo:t 2.2(04111102) <br /> Repbcer—Rcvis2om 2.1(11110100) Pare <br /> ` ?Iwavc a-v15�a25 <br />
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