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ARCHIVED REPORTS_XR0006039
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_XR0006039
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Entry Properties
Last modified
5/5/2020 2:38:19 PM
Creation date
5/5/2020 1:58:33 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006039
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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..r.r■ a� �r i� ttt>� t� f� i t� t� t� t� � � <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date 9- 3-0 Page c9- or 3 <br /> 837 Shaw Road- Stockton, California- 95215- (209)467-1006 - Fax (209)467-1118 <br /> Client Project Manager / Tests Required <br /> Phone Number <br /> ' 0 1606 1 <br /> Samplers (Signature) Invoice <br /> Pro)ect Name AGEENr <br /> eu Client ❑ <br /> Saple Type <br /> Sample Location Date TNo of <br /> Time Number Description Water Air Solid Cants � Notes <br /> Comp Grab <br /> q-xs-451 175,1 <br /> FW <br /> t ' <br /> P4L4J Do <br /> wins P u j&W14 <br /> l 1l5 Z. <br /> ►awr M k1l 2- <br /> PAW <br /> PAW 13A <br /> I3B tc W13 <br /> e inqui y ( ig ture) R ecerve y rgnature <br /> Date rime <br /> -OW-03 <br /> D <br /> Relinquished by (Signature) Received by (Signature) <br /> atelTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Datefrime <br /> Dispatched by (Signature) DalelTime R ceiva for Labors ry by atemme <br /> ( I v tg) 2qk&—,,K, <br /> Method of Shipmentr o ory Na <br /> I <br /> 5pectat Instructions �. �� 1 h reby authorize the performance of the above indicated work <br />
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