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ARCHIVED REPORTS_XR0005431
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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2402
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3500 - Local Oversight Program
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PR0545640
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ARCHIVED REPORTS_XR0005431
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Last modified
5/5/2020 2:39:23 PM
Creation date
5/5/2020 1:33:23 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005431
RECORD_ID
PR0545640
PE
3528
FACILITY_ID
FA0003900
FACILITY_NAME
PACIFIC PRIDE COMMERCIAL FUEL
STREET_NUMBER
2402
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95204
APN
12506001
CURRENT_STATUS
02
SITE_LOCATION
2402 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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LSauers
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EHD - Public
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CASTLE ANALYTICAL LABORATORY YAk9 114 CHAIN OF CUSTODY <br /> Location 2333 Shuttle Drive, Bldg 9061909, Atwater CA 95301 Certificate No 2079 <br /> Mailing Address 2333 Shuttle Drive Atwater, CA 95301 PAGE �OF <br /> Phone (209) 384 2930 Fax 12091 384-1507 <br /> Customer REQUESTED ANALYSES Method of Shipment <br /> Address l YOG 7 Al d21L SoN thf <br /> LO.Q? m a w C /1- T1 i'�NG'fG <br /> City/State/ZIO O �N N Fx a V, Motes �], / <br /> Phone ! FAX a _ ��,� p ]-/// v a m 1 ccibla i, me;vi-k <br /> Proj # 1 P 0 C.fl L ru E= } W ' 4 Co o ° 5eAkct +- ���A4+ <br /> Report Attention j r1 ��� J Q a FCL aK�k� <br /> Sampler Signature g N m o <br /> Panted < " tl <br /> Z <br /> Lab ID# SAMPLE ID D4TE TIME DESCRIPTIONILOCATION tai OBSERVATIONSIREMARKS <br /> k 30 L x ! <br /> 52973 <br /> 82974 <br /> I <br /> L <br /> SER 9N <br /> 0 2I <br /> HEAD SPACE ARS <br /> Total number of containers submitted to <br /> g a e Printed Name Date Time Company Name the laboratory <br /> Relinquished by ( e U /Z_y ,�v0 �1 Note All special requests(e g quick <br /> Received b L ,� Z'CC- j l-�3`�7 L turn times}must be cleared through <br /> y Cc authorized laboratory personnel <br /> Relinquished by <br /> Received by <br /> Relmgwshed by RESULTS DUE <br /> Received by VERBAL j wRITTEN <br />
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