My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
ARCHIVED REPORTS_XR0005431
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
P
>
PACIFIC
>
2402
>
3500 - Local Oversight Program
>
PR0545640
>
ARCHIVED REPORTS_XR0005431
Metadata
Thumbnails
Annotations
Entry Properties
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
Scanner
LSauers
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
103
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
ASTLANALYTICAL LABORATORY CHAIN OF CUSTOP <br /> C 985 # x�+C�sE33Co <br /> Location 2333 Shuttle Drive, Bldg 9081909, Atwater, CA 95301 Certificate No 2079 <br /> Mau+ng Address 2333 Shuttle Drive, Atwater, CA 95301 PAGE I OF I <br /> Phone {209) 384 2930 - Fax (209) 384-1507 T <br /> Customer w^ l ) 1) eil V t .fl i Ileall b� REQUESTED ANALYSES Method of Shipment <br /> Address _ � r7D5 �. �'� at v ti V'V !Li GI's r <br /> City/State/ZIP STCC K To G m o u, z Notes <br /> Phone 1 FAX �(:Ao) 14(,-7-1 L �v� �1 U 7-J 1 ro " � jd Z e46 tee led <br /> __l <br /> Prof # 1 P 0 # �. t< �V I�LS a _ w = m o . ' ° �ecef ved 6p�led <br /> tv � <br /> Report Attention t� W o ca z � o1�� <br /> T l r'l } -� ¢ n w a s �1ri lu <br /> Sampler Signature a- g `� m ~ ~ LU <br /> co <br /> Printed <br /> Z 82866 <br /> , <br /> Lab ID# SAMPLE ID DATE TIME DESCRIPTION&OCATION f, <br /> Au"I —14 <br /> 82887 i <br /> am - s" I X, 82868 <br /> 4W <br /> t , <br /> Rw - 2Q 828691 <br /> 1 <br /> M <br /> W Z- , <br /> 82871 1 <br /> 82872 <br /> wz-So 82873 <br /> wz-�S 82874 , <br /> 5P ► r <br /> 82875 <br /> P L <br /> 82876 <br /> Tot <br /> s n ure Printed Name Date Time Company Name J , 82877 <br /> q L�T'�—� 3 7� Il is f 2� Note A,�r._. _ <br /> Aelm unshed by <br /> Received by 4� ' 77t /011[47 g1 � 2ll L C turn times)must be cleared through <br /> caq authorized laboratory personnel <br /> Relinquished by <br /> Received by r OMER <br /> --F---7TTCUCrM <br /> Relinquished by [) RESULTS DUE <br /> Received by F <br /> VERBAL WRITTEN <br />
The URL can be used to link to this page
Your browser does not support the video tag.