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ARCHIVED REPORTS_XR0009066
Environmental Health - Public
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EHD Program Facility Records by Street Name
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U
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UNION
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425
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3500 - Local Oversight Program
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PR0545776
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ARCHIVED REPORTS_XR0009066
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Last modified
6/1/2020 11:44:29 AM
Creation date
6/1/2020 11:40:17 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0009066
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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EHD - Public
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ftF 'VHF Environmental Consultants; Inc. <br /> Post Office Box 672.9 <br /> Modesto, CA 95355-6729 <br /> CHAN OF CUSTODY- RE CORD (209) 579-8138 <br /> PROJECT NAME: ¢ V i 1 <br /> SAMPLERS (signature) : a <br /> Number �rz � . l� � (� � REMARKS <br /> Station v 1 'ice <br /> wmber Date Time u Station Location tainers6—z—/C) X>MX <br /> �� <br /> r <br /> rw^ `✓M` T+J Lam^'^ �• <br /> �Pl o _.,-2 Df d <br /> �v-C3 --•�� �� �r" _! ri �� <br /> ��- r3 --/ 30 --- - V <br /> 1 f <br /> Relinquished by(si nature): Date / Time R cei ed b/( ig ature Relinquished by(signature): Hate / Time Receivea by (signature): ' <br /> l f rY 'T-z Company or Agency: <br /> Com y or Agency: „�,� ompany Agenp Company or Agency: P Y 9 <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 /> si^nature) <br /> Company or Agency: <br /> f <br /> i <br /> r y � :.. _. _. <br />
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