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ARCHIVED REPORTS_XR0006755
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0543479
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ARCHIVED REPORTS_XR0006755
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Entry Properties
Last modified
5/5/2020 10:37:38 AM
Creation date
5/5/2020 9:56:18 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006755
RECORD_ID
PR0543479
PE
2960
FACILITY_ID
FA0024679
FACILITY_NAME
CANEPA'S CAR WASH
STREET_NUMBER
6230
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95204
APN
081360030
CURRENT_STATUS
01
SITE_LOCATION
6230 PACIFIC AVE
P_LOCATION
01
QC Status
Approved
Scanner
LSauers
Tags
EHD - Public
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CHAIN-OF-CUSTODY Condor Earth Technologies, Inc. <br /> ❑ 21663 Brian Lnne /� 1125 N Golden State Blvd,Ste H ❑ Agro Environmental Q 1100 C Airport Blvd <br /> N904, 42 <br /> o (!`�lY J, P 0 Box 3905 !1p 0 Box 3448 5651 N Pershing Ave,C 3 P O Box 30035 <br /> L V `r Sonora California 95370 Turlock,California 95381 Stockton,California 95207 Pensacola,Florida 32503 <br /> (209)532 0361 (209)668-9234 (209)474-1492 (904)477-0454 <br /> Fax(209)532 0773 Fax(209)668-9248 Fax(209)478-1716 Fax(904)477-0534 <br /> SHIPPED TO: J SEND RESULTS TO <br /> E'c� lG pY1 NAME <br /> f OFFICE <br /> C BILLING INSTRUCTIONS <br /> ❑ PLEASE FAX RESULTS LABORATORY REPORT NUMBER <br /> I <br /> PROJEC F NO r .�r, <br /> NO 4� <br /> SAMPLED BY of 44, 4�v fru <br />� 1 � con- ��' � ti�V Cy <br /> (Slgnattlre) l �.(.. �� G�L�' tarn_ �' �- 4 c{,+ <br /> Date Time Sample 1D ers Q0 �Q� 0 4' �' REMARKS MISC <br /> / / <br /> �yLf 7 7 � GL <br /> i <br /> i <br /> Relinquished By— Date Time Received By Date Time <br /> (Signature) (Signature) <br /> Relinquished Byuric Received By DateTime <br /> ( igna urc (Signature) <br /> Relinquished By NV <br /> Date Time Received By � D Time(Signature) �' i'�? �� Ij ?' (Signature) ; e <br /> Origmal-Scnd Yellow-File Pink-Log BA GAROLI GRAPHICS(209)5279887 FORM J$92 <br />
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