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ARCHIVED REPORTS_XR0005722
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_XR0005722
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Entry Properties
Last modified
5/5/2020 2:57:01 PM
Creation date
5/5/2020 1:53:50 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005722
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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�.wt■ tttttttttttw ttttti rti �� tiiiiiiiiiA i i i i i i i i i i i• <br /> Advanced CHAIN F USTOD RECORD <br /> -- GeoEnvironmental, Inc. Date Page Of <br /> 837 Shaw Road- Stockton, California- 95215 - (209) 467-1006- Fax(209)467-1118 <br /> Client Pro ect Mana r <br /> TesWRequired <br /> �! <br /> P umber <br /> rZneI) <br /> 6. _ ,Oo �. <br /> Sam s (Signature) Invoice <br /> Project Name s AGE <br /> r041 <br /> I Client ❑ <br /> r <br /> Sample Location SampkrType No <br /> Date Time Water Air <br /> Contsf <br /> Number Description Notes <br /> 113 <br /> Comp Grab <br /> e inquie by " <br /> a re ece ve y ignature <br /> DelTirrte <br /> 't-A- <br /> Reiinquis ed by (Signature) Received b Si �� <br /> y (Signature)) ate(Ttme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysts (Slgnatufe) DatelTtme <br /> Dispatched by (Signature) DatelTtme R ve for laboratory Datefrime <br /> L.2- 62-- �� <br /> Method of Shipment Laboratory N e <br /> aJ Cue H"t, r <br /> Special instructions I hereby rtze the p rfor ante of the above i icated work <br />
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