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SITE INFORMATION AND CORRESPONDENCE
Environmental Health - Public
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3500 - Local Oversight Program
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PR0545776
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
5/28/2020 4:51:36 PM
Creation date
5/28/2020 4:36:28 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545776
PE
3528
FACILITY_ID
FA0002231
FACILITY_NAME
JACK FROST ICE SERVICE
STREET_NUMBER
425
Direction
N
STREET_NAME
UNION
STREET_TYPE
ST
City
STOCKTON
Zip
95205
APN
15112003
CURRENT_STATUS
02
SITE_LOCATION
425 N UNION ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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S <br /> . V4iF WHF Environmental Consultants, inc. <br /> ` Post Office .Box 6729 <br /> CHAIN OF CUSTODY RECORDS� Modesto, CA 95355-6729 <br /> (209) 9-8138 <br /> PROJECT NAME: `PV /D/-j C�F C U <br /> Y2S N. 4 4)t 0 PJ S T. E 7cv,C-L7b AJ <br /> SAMPLERSiA <br /> Number <br /> of R <br /> StationCon- i <br /> Number Date Time a b Station Location tainers <br /> �3Gcz5 Ica' Z 1 (: t o fK# <br /> Relin wished by(signature): Date / Time Received by (signature): Relinquished by(signature): Date / Time Received by (signature): <br /> h0 6 <br /> Company or Agency: <br /> �21�/ 1 r Company or Agency: Company or Agency: Company or Agency: <br /> Relinquished by(signature): Date / Time Received by (signature): Relinquished by: Date / Time Received by (signature): <br /> Company or Agency: Company or Agency: Company or Agency: Company or Agency: <br /> Relinquished by(signature): Date / Time Received for Laboratory by: Date / Time Remarks/Shipping Information <br /> Company or Agency: (s n e) <br /> � /j :.0 <br />
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