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ARCHIVED REPORTS_XR0008057
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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P
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PACIFIC
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4405
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2900 - Site Mitigation Program
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PR0542364
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ARCHIVED REPORTS_XR0008057
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Entry Properties
Last modified
5/4/2020 3:38:19 PM
Creation date
5/4/2020 3:15:45 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008057
RECORD_ID
PR0542364
PE
2960
FACILITY_ID
FA0024340
FACILITY_NAME
PACIFIC CAR WASH
STREET_NUMBER
4405
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
11024014
CURRENT_STATUS
01
SITE_LOCATION
4405 PACIFIC AVE
P_LOCATION
01
QC Status
Approved
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LSauers
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EHD - Public
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CASTLE ANALYTICAL LABORATORY 2, 1 CHAIN OF CUSTODY <br /> Location 2333 Shuttle Drive, Bldg 9081909, Atwater, CA 95301 Certificate o 2079 <br /> Mailing Address 2333 Shuttle Drive, Atwater, CA 95301 PAGE OF <br /> Phone f209) 384-2930 - Fax (209) 384-1507 <br /> Customer r y� a REOUESTED ANALYSES <br /> Address Method of Shipment <br /> � � N <br /> City/State/ZIP © _ m e � o w <br /> Phone / FAX ©q -t_l DD 6 I �_ o w a dotes <br /> Prol # 1PE) # e ` a. Y-o as � R x w w r ,�' o <br /> Report Attention— EL w v R u a <br /> Sampler Signature a o m X <br /> til <br /> Lo <br /> 0 m <br /> I Printed <br /> �� r `� �i <br /> Lab iD# SAMPLE ID DATE TIME DESCRIPTIONILOCATIOM1! hilt ;'S <br /> S k 4 <br /> W Q 561345 <br /> Y, f <br /> ~ice1r <br /> tv5lo4� 00 <br /> R .t <br /> �+ c <br /> ` 11 <br /> �� <br /> X50 <br /> H+4 <br /> .�� 2ltllCi rated Dame Pate, +ted to <br /> Printed TImP Company Name I,',` ���>'� � ����J�� r <br /> Relinquished by /1r is l i <11 --21 !1D " <br /> Ci'Jr E' �'� �. Nc�� "e—ick <br /> Received by - -6 f tllli"r, <br /> fpr�s� w�tsi' ; t t aIgh <br /> Y r r a r <br /> Relinquished by auilF <br /> Received by <br /> '�+�f <br /> R! �I <br /> fieiinqusshed by ICUP �F f �A' �J RESULTS DUE <br /> n <br /> ReCBEVedby GOODC01,5ITIO� p i 'rr' T �"�` VERBAL WRITTEN <br /> R EST CGiJTr;INEHS <br />
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