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ARCHIVED REPORTS_XR0009377
Environmental Health - Public
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EHD Program Facility Records by Street Name
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T
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12 (STATE ROUTE 12)
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3049
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3500 - Local Oversight Program
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PR0545717
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ARCHIVED REPORTS_XR0009377
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Entry Properties
Last modified
11/19/2024 3:45:51 PM
Creation date
6/3/2020 11:15:36 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0009377
RECORD_ID
PR0545717
PE
3528
FACILITY_ID
FA0003912
FACILITY_NAME
MARTINIS BAIT & TACKLE
STREET_NUMBER
3049
Direction
W
STREET_NAME
STATE ROUTE 12
City
LODI
Zip
95240
APN
02514016
CURRENT_STATUS
02
SITE_LOCATION
3049 W HWY 12
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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LSauers
Tags
EHD - Public
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CHAIN-OF-CUSTODY <br /> Condo arth Technologies, Inc. Wal-07 <br /> L] 21663 Bnan Lanei 125 N Golden State Blvd,Ste H L] Agro Environmental 1100 C Airport Blvd <br /> f P O Box 3905 P O Box 3448 5651 N Pershing Ave,C-3 P O Box 30035 <br /> No- rL 350 2 Sonora,California 95370 Turlock,California 95381 Stockton,California 95207 Pensacola,Florida 32503 <br /> (209)532-0361 (209)668-9234 (209)474-1492 (904)477-0454 <br /> Fax(209)532-0773 Fax(209)668-9248 Fax(209)478-1716 Fax(%4)477-0534 <br /> SHIPPED TO: In1 SEND RESULTS TO Al 1r, 2 4 1994 <br /> (2--e-0 AV1 1 (A C.a_ NAME ylC <br /> OFFICE ___ I -k <br /> BILLING INSTRUCTIONS L) C-�_! 06� <br /> ❑ PLEASE FAX RESULTS LABORATORY REPORT NUMBER <br /> PROJECT NO 4s- 5 <br /> NO of <br /> 5 �~ <br /> SAMPLED BY cors_ <br /> (Signature) tain- <br /> Date TiSample ID ers O 4 REMARKS MISC <br /> I X Ix I Pa/979 <br /> F A90 <br /> [-z� �1 g <br /> � I <br /> -�S L3 - I x I IX Tal S <br /> Relinquished B �� Reeetved B �� Date <br /> (Signature) ( cgnature <br /> Relinquished By Date Time Received By to Time <br /> (Signature) (Signature) <br /> Relinquished By Date Time Received By Date Time <br /> (Signature) (Signature) <br /> i <br /> Original-Send Yellow-File P1nk-Log Book OARMIGRAAWC8120527W7FORM JM <br />
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