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ARCHIVED REPORTS_XR0008090
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_XR0008090
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Entry Properties
Last modified
5/4/2020 4:04:25 PM
Creation date
5/4/2020 3:25:48 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008090
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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tttttttttt■ ttttttttt� �� tttttttttn It[ttitt� �� It[[[[[[t� t>•� � � � � t>_ >_ �� �� <br /> Advanced CHAIN OF CUSTODY RECORD <br /> Date C1 1 2-44 Page 15—of CO <br /> GeoEnvironmental, Inc <br /> 837 Shaw Road - Stockton, California 95215 - (209)467-1006- Fax (209)467-1118 /0 <br /> Client Project Manager Required <br /> 4 <br /> Phone Number <br /> 2,0c4 t � —Lcj CACP <br /> Sa Iers Signature) Invoice <br /> AGE <br /> Project Name � l Ct li (c r �� v Client E]Sam le T <br /> Sample Location Date Time Water YPe Solid N° °t Notes <br /> Number Description Comp Grab Air Conts <br /> k"I'LAw L� � a 14r -2�-ILA >C 1 :3 <br /> tui , to c t 3 <br /> A(Az >C' <br /> MAA5G 123ce �C x <br /> n 3s e t ece ve y itu <br /> gnare- Datsf7 e <br /> R quishe y (Signatw Received by (Signature) Date ime <br /> � Z'7 /I Gtr <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Daterrim <br /> Dispatched by (Signature) Date/Time Received for Laboratory by DaterTime <br /> Method of Shipment A CoewLab tory Name <br /> ?�� I her authorize the performance of the ab ve indicated work <br /> Special Instructions <br />
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