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ARCHIVED REPORTS_XR0005417
Environmental Health - Public
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3500 - Local Oversight Program
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PR0545495
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ARCHIVED REPORTS_XR0005417
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Entry Properties
Last modified
3/13/2020 8:02:56 AM
Creation date
3/10/2020 4:45:03 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005417
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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f <br /> Ultramar Inc. ! BEACON <br /> 1 <br /> CHAIN OF CUSTODY REPORT 7 7,3 <br /> E�trarn.r <br /> Beacon Station No. Sample (Print Nam �alq �, Fo n No,_ <br /> ANALYSES (of <br /> Project No. S pier(Si tore) <br /> Project Lo elan <br /> x Wo <br /> 0 <br /> Sample NoAdentifscat'ion Date Time Lab No. m a z REMARKS <br /> S �/� —/aIGCI.9 /f���� •—a i <br /> S icy �rcv t -44 <br /> /T; �G <br /> lllJ.� x-71 /e -v7 f <br /> R nquis by:(Sature/Ailillation) Date Time Rece�iv�ed by: (SignaturelAffiliation)AQj Date Time <br /> c�y� t GL/U C/ -L �y�t vl.t C<-. t S. j: S <br /> elf quish b :(Signature/Affiliation a Time Received : (SignaturelAffilia'on} v' to Time <br /> Relinquished by:(Signature/Affiliation) Date Time Rec ' by: (Signature/Affiliation) Date Time <br /> ,r <br /> b <br /> � s �l� L1 UKh <br /> eport T Bill to: ULTRAMAPIING. <br /> 525 West Third Street <br /> rHanford, CA 93230 <br /> Attention: <br /> WHITE: Return to Client with Report YELLOW: Laboratory Copy PINK:Originator Copy u'O07A0 <br />
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