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ARCHIVED REPORTS_XR0012027
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_XR0012027
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Entry Properties
Last modified
10/10/2020 10:51:39 PM
Creation date
7/9/2020 8:28:38 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012027
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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w.� a . � i i i V tllllll� tlllll� <br /> CASTLE ANALYTICAL LABORATORY Sao %q$ CHAIN OF CUSTODY <br /> Location 2333 Shuttle Drive, Bldg 9081909, Atwater, CA 95301 Certificate No 2079 <br /> Mailing Address 2333 Shuttle Dave, Atwater, CA 95301 y PAGE_] OFJ <br /> Phone (209) 384-2930 - Fax (209) 384-1507 a <br /> Customer Cts REQUESTWANALYSES Method of Shipment <br /> Address W t a y <br /> City/State/ZIP B <br /> _ z <br /> rn Notes <br /> Phone / FAX �„- _ 12clij 4L-J7- It 4 W / <br /> Prol # 1P0 # , <br /> Report Attention tet- w _ = o <br /> Sampler Signature, 0. R m m � c,-' G� `� <br /> Printed <br /> �U z <br /> `Lab lD# SAMPLE ID DATE TIME DESCRIPTIONILOCATtON 'N OBSERVATIONSIREMARKS <br /> i <br /> /W Ig q 511 q- 94866 <br /> -3 as L <br /> U; � 94857 <br /> k - y l 94858 I <br /> rvul-5 - c <br /> {#> Vo-4c/2j j qacs L 94858 f� <br /> M _ 1fl-3 a6r l 94860 <br /> _ 94861 <br /> 94862 <br /> 94868 <br /> Total number of oontelners submitted to <br /> Signaturg Printed Name Date The Company Name the laboratory <br /> Relinquished by kfr ff�g v N Note All special requests(e g quick <br /> tum times)must be cleared through <br /> Received by fes/ �. �/ L 'Gi �� M� authorized laboratory personnel <br /> Relinquished dly, <br /> Received by ' , _ � ' <br /> Relinquished by g N1 IALJ 0THERESULTS DUE <br /> Received by <br /> ....... VERBAL WRITTEN <br /> HfA13SPACEABS <br /> EM_,,,.� C�1f1r'�is�r,ti <br /> I <br />
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