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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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,— +�� �� ■� i_ � i! ttt� tt� t� � � � � i• EEEEEEEE#EEEE#EE <br /> ( Advanced CHAIN F USTODY RECORD <br /> GeoEnvuorzme tat, Inc. �, j` � Date Page Of <br /> 837 Shaw Road- Stockton, California 95215- (209) 467-1006 - Fax (209) 467 1118 <br /> �ClEient Project Menage <br /> p L Uter-, <br /> Tests Required <br /> Phone Number <br /> Sari t (Sig re) Invoice, <br /> � -- <br /> Project Name AGE <br /> client <br /> Sample Type <br /> Sample Location Noof <br /> Number Description Date Time Water Air Solid Conl Notes <br /> Comp Grab <br /> Oz* <br /> - f <br /> -,7- <br /> e rnqujsatueceive y iganture am <br /> i) te/Ti e <br /> Relmq fished by (Signature) <br /> Received by (Signature) <br /> Data(Time <br /> Rehnquishad by (Signature) Received by Mobile Laboratory for Geld analysis (,Ygnature) Dateffime T� <br /> Dispatched by (Signature) Datelritne Be Laboratory b <br /> Method of Shipment <br /> L borivorm <br /> Special inatrucltons i` I herebya Drize the p ortnance ( the above indicated work <br /> 1 <br />
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