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ARCHIVED REPORTS_XR0005256
Environmental Health - Public
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EHD Program Facility Records by Street Name
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3500 - Local Oversight Program
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PR0545495
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ARCHIVED REPORTS_XR0005256
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Entry Properties
Last modified
3/10/2020 8:14:03 PM
Creation date
3/10/2020 4:31:41 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005256
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
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SJGOV\sballwahn
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EHD - Public
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U1110nar I=. ' <br /> �j BE�ON <br /> CHAIN OF STODY REPORT <br /> 1 7q y <br /> Beacon Station No. Samplerf( rpt Name) Date J Form No. 1 <br /> ANALYSES Z of -Z- <br /> 74/7 <br /> �Z y 3 14N�, s ,ar/�2 <br /> Project No. Sampler(S ature} <br /> Project Location Affiliation r- <br /> C 1 X y O <br /> Samle Noildentification Date Time Lab No. m zCT °I REMARKS <br /> -/V1 AN 0 11 <br /> 3 <br /> M1 30 <br /> -7/' u <br /> -�6 <br /> 0 -Z 07 <br /> LJ,- 0,C/ 2 8-.-,1- L�J -2 .2 ( 30 �g <br /> Relinquis ed : (Signature/Af Iia'on) Date Time Received by: (Signature/Atfiliation) Date Time <br /> Relinquished by:(Signature/Affiliation) Date Time Received by: (Signature/Affiliation) Date Time <br /> Relinquished by:(Signature/Affiliation) Date Time Received by: (Signature/Affiliation) Date Time <br /> Report To: 1 l - nrrt_ f,cu,i �z <br /> Bill to: ULTRAMAR INC. <br /> q� 525 West Third Street <br /> Hanford, CA 93230 rr�� <br /> Attention: <br /> WHITE: Return to Client with Report YELLOW: Laboratory Copy PINK:Originator Copy � <br /> I <br />
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