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EnvironmentalHealth
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EHD Program Facility Records by Street Name
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PACIFIC
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4511
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3500 - Local Oversight Program
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PR0545641
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SITE HISTORY
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Entry Properties
Last modified
5/5/2020 2:45:53 PM
Creation date
5/5/2020 2:10:17 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE HISTORY
RECORD_ID
PR0545641
PE
3528
FACILITY_ID
FA0002480
FACILITY_NAME
SHOP N GO 3
STREET_NUMBER
4511
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
11023011
CURRENT_STATUS
02
SITE_LOCATION
4511 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
LSauers
Tags
EHD - Public
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.vATERWORK <br /> CHAIN-OF-CUSTODY RECORD AND ANALYSIS REQUEST <br /> Cn PROJ.NO. PROJECT NAME ANALYSIS TYPE REQUESTED <br /> ao Z1vs /C.O/? ! azc-f C A I`C Q <br /> [SAMPLERS: Signature) a w <br /> cc w a <br /> �T A Z <br /> =014,0 o w <br /> I.D.NO. DATE TIME 0 STATION&LOCATION <br /> U C7 N /` REMARKS <br /> w � ��i, catf'�c fz < 0W l S5 <br /> U F A-PLq 21.0' 51. .� <br /> , <br /> a Golf�c 8 Me 4(U�vxx <br /> i <br /> PLEASE RETURN ICE CHESTS <br /> AND BLUE ICE TO WATERWORK. <br /> LAB. jj�PFIIM� GR. <br /> Relinquished by. Date Time Received by: n•� Relinquished by: Date Time Received by: <br /> ,4cq, F <br /> Relinquished by: Date Time Re ived by: Relinquished by: Date Time Received by: <br /> Relinquished by. Date Time fie ived by Lab t Date Time REMARKS(Shipping Related): <br />
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