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ARCHIVED REPORTS_XR0008061
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_XR0008061
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Entry Properties
Last modified
5/4/2020 3:56:24 PM
Creation date
5/4/2020 3:16:46 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008061
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
Scanner
LSauers
Tags
EHD - Public
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..� r: ■ww e��r a•ttttt� t� t� f� � Ili 1tl• 1tl• � � � � � � <br /> i ! <br /> l <br /> Advanced CHAIN OF CUSTODY ECORD <br /> GeoEnvironmental, Inc. Date—4/21,/vr Page _ I of Z <br /> 4005 North Wilson Way-Stockton,Cafiforrtia-95205-(209)467-1006-Fax(209)467-1118 <br /> Client Project Manager <br /> Tests Required <br /> EGG Afl, <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> Protect Name AGE ML' w�S Client ❑ <br /> Sample Location Sample Typepate Time Water Solid N° of J Notes <br /> Number Description comp Grab AIC Conts <br /> -3/o6 24 10l !G Z!J <br /> �zl5- of 3 <br /> ws� aJ <br /> /MwG <br /> I ITTTI <br /> Re nquis y ( i nature) Received by (Signature) Date[Time <br /> Relin ed by Kgriefurel Received by (Signature) `j` �DaterTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatelTime <br /> Dispatched by (Signature) DatelTime Received for Laborator y Date1T me <br /> J..aJ2"2 Method of Shipment Laboratory Name <br /> ��C�N� 4 <br /> Special Instructions 1 hereby aut raze the performance of the ave indicated work <br />
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