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ARCHIVED REPORTS_XR0008134
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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3500 - Local Oversight Program
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PR0545641
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ARCHIVED REPORTS_XR0008134
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Entry Properties
Last modified
5/5/2020 3:28:20 PM
Creation date
5/5/2020 2:28:37 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008134
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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( Advanced CHAIN PF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Iqa mac{ Date Page of <br /> 4005 North Wilson Way-Stockton California-95205-(209)467-1006-Fax(208)467-1118 <br /> Client Project Manager <br /> Tests Required <br /> P e umber <br /> 2ts� a�(� •y <br /> am rs (Signature) Invoice <br /> Project NameAGF <br /> v4viv- .00 Client ❑ <br /> Sample Location pate Time Sample Type Solid No, of <br /> Number Description Water Air Conts Notes <br /> comp (arab <br /> +)AUA n to k i= 36494 <br /> .02 3 MI6 X k k a 36495 <br /> t+� �i 5 <br /> r I <br /> 6M w 1-1 lbq-A-00 :0-4 kill -V 35 01 7 <br /> _ <br /> 1 <br /> /0 tit l 0356 1 4 X 364918 <br /> 36499 <br /> VVI "dD t t t ? E\,\. <br /> I;. ;_0 �lngo ey ,gnat a jo go�ture � � O� <br /> 7 <br /> Rehnqu, he0dby 61 et re} r Received by (Signature) Date rime <br /> VAS GIMETAISJOIR <br /> Relinquished n liLd JiVMTIUI ed fN All Laboratory for field analysis (Signature) Date/Time <br /> GOOD CONDITIO TNN� <br /> Dispatched bHB@SMf� CONnatelTima Received for Laboratory by Date/Time <br /> Method of S tent VV nt La"laJory ame <br /> Special Instructions I hereby authorizell the performan a of t above Indicated work <br /> _ _ C,���E�' ,ice r✓c�c�Ste.�� o�.�.,��•���1� <br />
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