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ARCHIVED REPORTS_XR0008838
Environmental Health - Public
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EHD Program Facility Records by Street Name
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W
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WATERLOO
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2358
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2900 - Site Mitigation Program
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PR0543607
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ARCHIVED REPORTS_XR0008838
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Entry Properties
Last modified
10/10/2020 10:40:06 PM
Creation date
7/9/2020 10:16:51 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008838
RECORD_ID
PR0543607
PE
3528
FACILITY_ID
FA0006343
FACILITY_NAME
STOCKTON MOBIL 3*
STREET_NUMBER
2358
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95205
APN
14118221
CURRENT_STATUS
02
SITE_LOCATION
2358 E WATERLOO RD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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LSauers
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EHD - Public
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V amar Inc. BEACON <br /> CHAIN OF CUSTODY REPORT r 2 7s <br /> IIJ m r <br /> Beacon Station No Sampler(Print Name) Daytfj Form of No 3 <br /> { ANALYSES <br /> Project No / Sa ler( ature) <br /> 1419 l _ 'V y <br /> Project location ffdi bn <br /> J1I o <br /> Sample NoAdentification Date Time lab No 1-2a z° REMARKS <br /> .s— - S - - z-' 3 0 <br /> -Tr --SB 739 <br /> f - S Zi <br /> tS 1 <br /> 3: v _ 02 <br /> -5 - o <br /> 4-Q '/z —S '/S o3 xi <br /> S—� --S 3' Z? <br /> --.s 3 <br /> S-- s 3: S --701 1 l <br /> 3 ' s <br /> r _ 7 Yz—SJ3 17 ' L <br /> -J r C <br /> Renuis by=(Signatffiliatio Date Time ,Received by (Signature/Affiliation) Date Time <br /> i <br /> eh ish ( nature/Affili tion) Date Time Received by (Signature(Affdiation) Date Time <br /> Relinquished by (Signature/Affiliation) Date Time Rece ed by (Signature/Affiliation) Date Time <br /> pw"C/ <br /> Report To B to ULTRAMAR INC <br /> 525 West Third Street <br /> �? l <br /> Hanford,CA 93230 <br /> —,P5 v - 2,/7L Attention / �.J O e AL. 44/zle <br /> WHITE Return to Client with Report YELLOW Laboratory Copy PINK Originator Copy 7210D3A0 <br />
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