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ARCHIVED REPORTS_XR0012023
Environmental Health - Public
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EHD Program Facility Records by Street Name
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W
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WILSON
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101
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2900 - Site Mitigation Program
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PR0541653
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ARCHIVED REPORTS_XR0012023
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Entry Properties
Last modified
10/10/2020 10:50:14 PM
Creation date
7/9/2020 8:26:13 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012023
RECORD_ID
PR0541653
PE
2965
FACILITY_ID
FA0023871
FACILITY_NAME
TOP FILLING STATION
STREET_NUMBER
101
Direction
S
STREET_NAME
WILSON
STREET_TYPE
WAY
City
STOCKTON
Zip
95205
APN
15125307
CURRENT_STATUS
01
SITE_LOCATION
101 S WILSON WAY
P_LOCATION
01
QC Status
Approved
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LSauers
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EHD - Public
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CASTL ANALYTICAL LABORATORY Flr 2g4 q CHAIN OF CUSTODY <br /> Location 2333 Shuttle Drive, Bldg 9081909, Atwater, CA 95301 Certificate No 2079 <br /> Mailing Address 2333 Shuttle Drive, Atwater, CA 95301 PAGE/OF <br /> Phone 1209) 384-2930 - Fax (209) 384-1507 <br /> Customer REQUESTED ANALYSES Method of Shipment <br /> Address - da 0Hf- <br /> Clt IStatelZlP r w <br /> Phone / FAX ��. C� F C.1a Notes <br /> Pro) # IPD # 7 U, ui o o <br /> 4 Lu Report Attention a ^ a o <br /> Ix <br /> Sampler Signature $ m ~ r m <br /> Printed u <br /> Z <br /> Laub IN SAMPLE ID DATE TIME DES CRIPTION&OCATION OBSERVATIONWEMARKS <br /> r 0 <br /> + - 3 s X 23933 <br /> r L <br /> 23534 <br /> + <br /> 23535 <br /> 21539 <br /> �- - V Lo ( 4.30 L 23537 <br /> ,- <br /> ,A 23538 <br /> 23539 <br /> 49AIN-ERS <br /> 23540 <br /> � P <br /> - Total number of containers submitted to <br /> - tura Printed Name Date Time Company ame the laboratory <br /> Relinquished by ZZr., r- eC ,0 ir Note All special requests{e g quick <br /> Received by tum umea)must be Geared through <br /> +� authorized laboratory personnel <br /> Relinquished by <br /> j Received by <br /> i <br /> Relinquished by RESULTS DUE <br /> Rene+ved by VERBAL WRITTEN <br />
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