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ARCHIVED REPORTS_XR0005441
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_XR0005441
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Entry Properties
Last modified
5/5/2020 2:09:13 PM
Creation date
5/5/2020 1:38:28 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005441
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
Tags
EHD - Public
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i i i i i i l• i i i i t• � � � t� t� itiiiiiii� tiiiiiiii� <br /> Advanced <br /> CHAIN OF CUSTODWECORD <br /> j 1-Z <br /> S � <br /> -- GeoEnvlronmental, Inc Date Z Page of <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 <br /> ClientA to D P �n� S� ri iv1 Project Manager / ! Tests Requi e <br /> � p � G k tl�d 6 <br /> Phone Number <br /> Samplers (Signature) `+ Invoice <br /> X <br /> Project Name C U r 5 - Client ❑ <br /> Sample Type � <br /> Sample Location Date Time Water Solid No of Notes <br /> Number Description comp crab Air Conts <br /> L4 x x k <br /> ►Z rt - Y <br /> 3 ,2-Vc(l -tq K <br /> e m uis e y (Signature} Received y ( ignatur Dale/Trme <br /> � stili 7, <br /> Relinquished by (Signature) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for lield analysis (Signature) Date(Trme <br /> Dispatched by (Signature) Date/Time Received f oratory y DatelTime <br /> le��V I / f /0 <br /> Method of Shipment Laboratory Name <br /> s <br /> Special instructions I hereby authorize lihe pe formance of the above Indicated work <br />
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