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ARCHIVED REPORTS_XR0005256
Environmental Health - Public
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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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liar Inc. <br /> BON <br /> ule+arrrr <br /> CHAIN OF STODY REPORT <br /> 1-7 ly <br /> Beacon Station No. Sampler(Pi Name) ate Farm No. "2 <br /> l ZZY 7 / <br /> — �, L �L/ �, ANALYSES 'Z�' of 2 <br /> / 3 <br /> Project No.. L J Sampler ignature) <br /> Project SLocation Affiliation <br /> 0 <br /> SaMple NoAdentificaiion Date Time Lab No. m z° REMARKS <br /> t� 13 <br /> ,('J'J U 2 --fit w I r ; 4" o _ It <br /> CA) q �. -. �U i .Z 5 ; 3U _ ,z <br /> c, Z - )3 <br /> I V <br /> r � <br /> HI <br /> 1 j <br /> t <br /> i <br /> Relin u, by: (S ignature/Affifiat n) Date Time Received by:(Signature/Affiliaiion) Date Time <br /> e t <br /> 5'4c <br /> , m <br /> Relinquished by:(Signature/Affiliation) Dale Time 13eceived by: (Signature/Affiliation) Date Time <br /> Relinquished by:(Signature//Affiliation) Date Time Received by: (Signature/Affiliation) Date Time <br /> Ilqzqol i70 <br /> Report To: Bill to: ULTRAMAR INC. <br /> 525 West Third Street <br /> CA 93230 <br /> Attention, <br /> WHITE: Return to Client with Report YELLOW: Laboratory Copy RINK:Originator Copy u- +� <br />
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