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ARCHIVED REPORTS_XR0007988
Environmental Health - Public
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EHD Program Facility Records by Street Name
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W
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WEST
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3302
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3500 - Local Oversight Program
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PR0545872
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ARCHIVED REPORTS_XR0007988
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Entry Properties
Last modified
7/21/2020 4:14:10 PM
Creation date
7/21/2020 4:09:54 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007988
RECORD_ID
PR0545872
PE
3528
FACILITY_ID
FA0025947
FACILITY_NAME
JAYS MINI MART
STREET_NUMBER
3302
Direction
N
STREET_NAME
WEST
STREET_TYPE
LN
City
STOCKTON
Zip
95204
APN
11705037
CURRENT_STATUS
02
SITE_LOCATION
3302 N WEST LN
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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LSauers
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EHD - Public
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ATC ASSOATES, INC <br /> CHAIN OF CUSTODY - <br /> Project Information Report To Samples Submitted To <br /> Project No -7111,•C-Y'�� j Consultant ATC Associates Inc Laboratory Argon Labs <br /> Project Title t' e 1 c,Y1 / J 2 1 Address 1117 Lane Palm Avenue Suite B Address 3037 5111 Street <br /> Location J JJ Modesto,Calrfor(�la 95351 + Ce s CA 95307 <br /> U�L1f LctYl£ S,#ccr far,r LA Contact �{p V,—, R r�eM Contact � {! <br /> Sampler s Name — I Phone (209)581 9280 <br /> t�.K ��p Y�$ (209)579 2221 Phone <br /> (print) Fax (209)579 2225 Fax (209)581-9282 <br /> Sampler s SignatIfTe A Bill To bate Results Required <br /> Client Same Date Report Required <br /> Address <br /> TURN AROUND ME ANALYSIS <br /> RUsli 24 Hour 413 Hvur Standard Special <br /> 15 Day) (10 Day) 'A <br /> ❑ 0 0 0 V4 <br /> C <br /> w N <br /> m aN m <br /> q. c1 to <br /> o- a w r'Ov N o COMMENTS <br /> Sample ID Data Time #Containers will. Preservative <br /> NIUJ MIZb an S ✓ ✓ V, NC,i Tito- <br /> J/ <br /> to <br /> W2 l+2JD ✓ ✓ <br /> Relingnls1 By Rate Time Receive B ( Date Time SPECIAL INSTRUCTMNSS'ilhinlIr' — Gi <br /> 4- a <br /> Relinquished By Date Time Received By Date Time �`�G a� 7L) ARO `OT7,0pg59 <br /> Relinquished By Date Time Received Sy pate Time <br />
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