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ARCHIVED REPORTS_XR0008069
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_XR0008069
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Entry Properties
Last modified
5/4/2020 3:50:11 PM
Creation date
5/4/2020 3:18:37 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008069
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 <br /> CASTL ANALYTICAL LABORATORY-,7c-;� � � � `��,�� CHAIN OF CUSTOP <br /> Location 2333 Shuttle Drive Bldg 9081909 Atwater CA 95301 Certsficate No 2079 G <br /> Mailing Address 2333 Shuttle Drive, Atwater CA 95301 PAGE ! OF f <br /> Phone 12091 384 2930 Fax (209) 384 1507 <br /> Customer 1' �, REQUESTED ANALYSES Method of Shipment <br /> ti A <br /> Address 40055 1t. Y-EI:l— Wxv b ;, a 0VerN+ hf- <br /> CitylStatelZlPC 2U � y � o '' �Notes <br /> a <br /> Phone 1 FAX �Cr 7— 20r �1 a w �_ § b 9 W w W i z <br /> _ 0 o <br /> Proj # / a r <br /> Report Attention W o zi _ o <br /> CL -OL Sampler Signature CL m <br /> Printed y <br /> Lab ID# SAMPLE ID DATE TIME DESCRIPTIONILOCATION tL ii ' w'S <br /> � � .�35.3.E <br /> ,off <br /> / { I7; ��; r 35 083 <br /> W 3 <br /> ,tm,QY <br /> � �Jr�° _. Yytt � �1 <br /> "4 W�le f 3V.L O <br /> y <br /> M' <br /> 0 i Yui 'J �7}� i n��''`� a <br /> �} w <br /> R;r°a ; <br /> r-s <br /> `r t <br /> 5 � <br /> 100 <br /> �S •*L�.��3 <br /> nature Printe Name d to Time Company Name Z u,�la lait,� <br /> Relinquished by i �} Y �� Note All special requests(e g quick <br /> Received by+ " ' L V ! '�� 7� t� turn times)must be cleared through <br /> k authorized laboratory personnel <br /> Relinquished by <br /> Received by <br /> Relinquished by ti; �_,IF I,}'I�i ✓ A �ts r;, ` � RESULTS OUE <br /> Received byrA "n Arlf� r � h���L�iJ , D VERBAL WRITTEN <br />
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