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ARCHIVED REPORTS_XR0003013
Environmental Health - Public
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EHD Program Facility Records by Street Name
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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_XR0003013
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Entry Properties
Last modified
1/30/2020 4:14:00 PM
Creation date
1/30/2020 3:34:44 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003013
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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e �of E_ <br /> Chain of C st0 y Word on-site Time: Temp: <br /> Project Name _ ,r c �! Off <br /> -site Time: Temp: <br /> p <br /> BP BU/GEM CO Portfolio: Sky Conditions: <br /> _ BP Laboratory Contract Number: eteorological Events: <br /> Date: _ �. Requested Due Date(mm/dd/yy) 51,,p4G• 4r- 7/le'4_ JWind Speed: Direction: <br /> Send To: BP/GEM Facility No.: Consultant/Contractor: r� • <br /> Lab Name: P/GEM Facility Address: 14,l 4 �,,�,� ,;.a,�,. �j <br /> d, Address: 3�67wr. <br /> Lab Address: Site ID No. `Ll <br /> y.' Site Lat/L.ong: e-mail EDD: <br /> California Global ID 3 Consultant/Contractor Project No.: <br /> Lab PM: BP/GEM PM Contact: �„rvt dY. Consultant/Contractor Tele/Fax: 9 X79 <br /> Tele/Fax; Address: onsultant/Contractor PM: —7r4 4r" <br /> Report Type&QC Level: Invoice to: Consultant/Contractor or BP/GEM (Circle one) <br /> BP/GEM Account No.: Tele/Fax: P/GEM Work Release No: 54?4.•I4 j <br /> Lab Bottle Order No: Matrix Preservatives Requested Analysis <br /> q <br /> Item Sample Point Lat/Long and <br /> No. Sample Description Time a Laboratory No. C4 Comments <br /> w ao ao <br /> r 3 P Ia z x x ca ca u� u3 <br /> 1 � <br /> 7 <br /> a <br /> 9 <br /> 10 ' <br /> Sampler's Name:,["A y,i, Tbw ceepted By/Atflliatilon Date Time <br /> Sampler's Company: .f:7J. / '^'� f`• 7�J�^i 4'•� 2 4 .L V,:i <br /> Shipment Date: <br /> Shipment Method: 51.- <br /> Shipment <br /> 1.Shipment Tracking No: <br /> Special Instructions: <br /> Custody Seals In Place Yes _No Temperature Blank Yes No Cooler Temperature on Receipt °FIC Trip Blank Yes No <br /> CON SU LTANT/CONTRACTOR BP COC Rev.1 215/02 <br />
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