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ARCHIVED REPORTS_XR0008120
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0545641
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ARCHIVED REPORTS_XR0008120
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Last modified
5/5/2020 3:37:53 PM
Creation date
5/5/2020 2:22:19 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008120
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
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EHD - Public
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McCampbell Analytical Inc. CHAIN-OF-CUSTODY RECORD Page 1 of 1 <br /> 110 Second Avenue South,#D7 <br /> Pacheco,CA 94553-5560 <br /> (925)798-1620 WorkOrder 0203358 <br /> Client <br /> Advanced GeoEnvironmental TEL <br /> 837 Shaw Road FAX <br /> Stockton, CA 95215 ProtectNo Pacific Mini Mart- <br /> PO 20-Mar-02 <br /> Requested Tests �------_- _--�T-�--- - _ <br /> Sample ID ChentSamplD Matrix Collection Date Bottle [:�200_7 SM4500H+B SW8015C SU21B18015 — — <br /> 4203358-001 Influent —Water T 3120102 __ --- A <br /> -- r I <br /> 4203358_002 - -- Etlent _ - Water_ 3120102_ T _ D _-_ C A <br /> Comments. <br /> - - -- ----� Date/Time ------- — --- DatelTmie <br /> Relinquished by Received by <br /> Relinquished by. _ Received by <br /> Relinquished by Received by <br /> NOTICE Solid samples are discarded after 60 days and Non-Solid samples are discarded after 30 days unless other <br /> arrangements are made Hazardous samples will be returned to client or disposed of at client expense <br /> Bottle Type l.-titer V-Voa S-Soil Jar 0-Orbo T-Tedlar B-Brass P-Plastic OT-Other <br />
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