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ARCHIVED REPORTS_XR0005246
Environmental Health - Public
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3500 - Local Oversight Program
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PR0545495
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ARCHIVED REPORTS_XR0005246
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Entry Properties
Last modified
3/11/2020 8:37:46 AM
Creation date
3/10/2020 4:25:10 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005246
RECORD_ID
PR0545495
PE
3528
FACILITY_ID
FA0006423
FACILITY_NAME
STOCKTON MOBIL 2
STREET_NUMBER
3440
Direction
E
STREET_NAME
MAIN
STREET_TYPE
ST
City
STOCKTON
Zip
95205
CURRENT_STATUS
02
SITE_LOCATION
3440 E MAIN ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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tANALY77CAI <br /> �� Davi 2nd Street, Suite 300 <br /> Davis,CA 95616 <br /> ccc Lab 530 297 4800 1 <br /> Fax 530 297 4808 �3_ _ i <br /> Protect C tact copy or,P To) �h No Page of <br /> it vv� Jl/{""+ California EDF Report? Yes U No <br /> { Chain-of-Custody Record and Analysis Request <br /> Company/ ddress% IZecur.na�rledbutnot fo lhiaa.ctlor� <br /> Sampling Company Log Code <br /> hone Analysts Request a <br /> F�t�6 <br /> global ID <br /> r �- 0 n . a <br /> i b -� 7- C-14 <br /> �lert Numt>er� P o EDF Dally ble To( all Addre a) CL 7 [r , � o 8 � a <br /> Pro,et Name �L1 L W t�,-wf { '"[+y��+ Sampler Signature , m N a p <br /> (�T `i 1 ( r W '� to aG W d IIA <br /> Project Address o 6 �, N a <br /> Sampling Contain r Prese ative Matrix 00 <br /> _ h az N m O J N <br /> G w a �/ ii <br /> E w C w 9 9 0, � co, e � <br /> Sample Desi nation Date Time a v + Z o a s �+ _ _ F x a 1 N <br /> z z — S' to '- a a o 0 0 0 �+ ¢ m r <br /> —t m ID F F in 1� iii N _5 W N <br /> V l 5yt ?c <br /> 010 o I <br /> D� <br /> Relinquished by Q ( 8 Time Received by <br /> Remarks <br /> RelinquishedO TAq <br /> Date oma Received by 1 ' 1 <br /> Relrnqurshed byJ rl x"11 <br /> Date Time rived by l.abora ry r <br /> uow5 / Bill to <br /> Drshibutron While-Leh, Pink-Ong��ator -�7/dim 1 /Cq f '�VRVj 4 "4-1 <br /> Formslcoc 121001 fh9 <br /> II <br />
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