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ARCHIVED REPORTS_XR0005713
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_XR0005713
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Entry Properties
Last modified
5/5/2020 2:35:26 PM
Creation date
5/5/2020 1:47:58 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005713
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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Advanced <br /> CHAIN OF CUSTOAECORD <br /> - GeoEnv�ronmenta , Inc Date !Z-zz- Page of Z <br /> 4005 North Wilson Way Stockton,California-95205 (209)467 1006-Fax(209)467-1118 <br /> Client Project Manager <br /> Tests Required <br /> TF rn <br /> Phone Number <br /> D,n1 - Liu 7- loo , <br /> Samplers (Signature) <br /> y <br /> Invoice <br /> <1 AGS � <br /> Project Name CAL <br /> L - v 1� Client El <br /> e, <br /> sample Location Date Time Sample Solid ype No of Nates <br /> Number Description <br /> Comp <br /> mp arab Air Conts I <br /> 56§34+ <br /> AWA tL 2,oa AW — tt-z 1-Cao (,7 3 U X 3 n �Av– 56 <br /> Aw13 /izzlod tZzI 0U1450 <br /> /� x <br /> A'-,;IA Ll,du Ate+ -7- A it-Zt-c)u iLlito 56936-' <br /> AwAghzz,00 AvJ – -6o .5 �( X 56931' <br /> �w) / 12.2101t-zt-ac 1410 X -3 X n 55i93Br <br /> I <br /> MwZ / I LI\ot) Mw - 2- 14155 x —2' X X 56,939X <br /> MW-1 /lUtOO fV\ _3 (Z-Z+ I(VAS X 3 X 56940' <br /> e to uts e y (Signature) y (signature) DatelTime <br /> may, 5 t2-22-OV 081-S <br /> Re quashed by (Signature) Received by (Signature) DatelTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysts (Signature) Date(Ttme <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Date/Time <br /> - . i 3v <br /> Method of Shipment <br /> Laboratory Name <br /> G 1 QVp—rL C.aih e �1 <br /> Special Instructions �� "' i1 t hereby authorize the performanob of the above Indicated work <br />
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