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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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Entry Properties
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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LSauers
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EHD - Public
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� � C <br /> L)0 9,C) <br /> WH F Environmental Consultants, Inc. <br /> Post Office Box 6729 <br /> _ - <br /> CHAIN OF CUSTODY RECORD Modesto, CA 95355-6729 <br /> (.209) 579-8138 <br /> PROJECT NAME: <br /> SAMPLERS (signature) <br /> b / <br /> Number <br /> Station of / �/ REWRKS <br /> Humber ate Time E b Cod_ r �O� <br /> Statian Location Q �� <br /> V h <br /> tainers ,� �`o�r�d <br /> � :o: o <br /> 7 ,� [� OLj <br /> i <br /> S-i } <br /> 114 <br /> — i r <br /> -4- <br /> �v — —`'`' <br /> Rel' quished b rsi ure Date I <br /> J � / )• r / Time Re; ' ed y s' nater Relinquished ty(signature): Date J Time Received b <br /> •� � , y (signature); <br /> ompan or Agency: ! Cofi an or A en <br /> ---------------- <br /> �'' W1Y`� ^�, ronin j•3pP g! c Company or Agency: Company or Agency. <br /> O e_n <br /> Relinquished b si natsre Date / <br /> q y( 9 ): / Time Received by (signature); Relinquished'-by: Date <br /> / Tim,. Received by (signature); <br /> Company or Agency: Company or Agency; Company or Agency: <br /> Company or Agency; <br /> Relinquished by(signature): Date / Time Received for Laboratory by: Date / Time Remarks/Shipping Information <br /> Company or Agency: (signature) <br />
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