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ARCHIVED REPORTS_XR0008098
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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4511
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3500 - Local Oversight Program
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PR0545641
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ARCHIVED REPORTS_XR0008098
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Last modified
5/5/2020 3:13:23 PM
Creation date
5/5/2020 2:18:24 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008098
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
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LSauers
Tags
EHD - Public
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� Advanced ( <br /> CHAI OF CUSTOC&ECORD <br /> GeoEnvironmental, Inc. <br /> Date � �� [C� Page of <br /> 837 Shaw Road-Stockton, California- 95215- (209)467-1006 - Fax (209)467-1118 �c $57 <br /> Client ' P D Alt ager Tests Required <br /> PhNumber <br /> 7 6,s-, lJ q�J7- (Ccke �7 <br /> Samplers (Signatur Invoice <br /> AGE <br /> Project Name - F S f <br /> ChentEl <br /> Sample Type <br /> Sample Location Date Time )Vater Solid No of Al Notes <br /> �ii <br /> Number Description Comp Grab Air Coats �y <br /> Kkur rl <br /> r Wr- <br /> e inqu ad by ( n re} eceive y rgnakure Datelrr, e <br /> t; c <br /> Relinquittred by (Signature) Received by (Signature) Date1'rime <br /> Relinquished by (Signature) Received by Mobile Laboratory for held analysis (Signature) Date(Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by �� QalelTime <br /> Method of Shipment �y _ ,� ti Laborat me <br /> CJ k <br /> Special Instructions <br /> _ 1 hereby authorize t perfor \r ce of the above Indicated work <br /> r <br /> \J <br />
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