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ARCHIVED REPORTS_XR0005396
Environmental Health - Public
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3500 - Local Oversight Program
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PR0545495
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ARCHIVED REPORTS_XR0005396
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Last modified
3/11/2020 8:48:02 AM
Creation date
3/10/2020 4:37:05 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005396
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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{. Ultramar Inc. BEACON <br /> `s CHAIN OF CUSTODY REPORT <br /> lltt�arr�ar_ <br /> Saaean Station No. Beacon 474 Sampler(Print Name) Date Farm Na. <br /> ANALYSES 6 D _yam of <br /> Hal Hansen <br /> Project No, 54-979-01 Sampler(Signature) <br /> Project Location Affiliation Doulos Environmental 4) <br /> Stockton, CA M <br /> as U <br /> 0 0 o <br /> I � _ <br /> Sample NoIldentification Dale Time Lab No. REMARKS <br /> -1 6-. -O.q�5q30 12234_01 a- <br /> -2 j 12234-02 <br /> -3 1 12234-03 <br /> 12234- <br /> 1 12234- CwVE;D <br /> 12234- <br /> 12234 271 <br /> ` 12234- WEST LAB <br /> I <br /> f Relinqulshed .(Signature/Affiliation) Date Time Received ( ature/Affillado bate Time <br /> of l d b is Data Time Re 'gn u ii Date Time <br /> iii uldh&fj(1F1g lation Date Time Received by: (Signatu is Time <br /> Report 70. Sheila Aichgeta !3111 To: ult r <br /> rugzo Weet, Inc. 52 5I 3rd Street <br /> 1050 Melody Lane, Suite 160 Hanford, CA 93230 <br /> Roseville, CA 95676' Attention: Randy Stephenson <br />
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