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ARCHIVED REPORTS_XR0008139
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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PACIFIC
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3500 - Local Oversight Program
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PR0545641
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ARCHIVED REPORTS_XR0008139
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Entry Properties
Last modified
5/5/2020 3:38:08 PM
Creation date
5/5/2020 2:30:13 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008139
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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Advanced CHAIN 9F PUST007RECORD <br /> GeoEnvironmental, Inc. Date /O/Z-71W Page <br /> Of <br /> 4005 North Wilson Way-Stockton,California 95205-(209)467-1006-Fax(209)467 1118 <br /> Client ?' Prol Man r <br /> Tests Required <br /> �% c> Phone Number <br /> S mpl s (Si nature) Q� Invoice. <br /> Project Name AGE <br /> Client ❑ <br /> Sample Location Sample TypeDate Time No of <br /> Number Description Water Air Solid Conts Notes <br /> Comp Grab <br /> bj -3 5 24259 <br /> I,t'J oZ �f �� S� �' �/ 242% <br /> 0 � 24299 <br /> 24260E <br /> �r r r �f 317 2425 1- <br /> lif 13 O'-L- 5 <br /> 5 <br /> rt 24262 r 3�, S <br /> e in urs d by rgnature ec iv yrgn tui lir 24r ¢y 24263 <br /> Rear quashed by Signatu Received by (Signature) DaterTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for held analysis (signature) DaterTime <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Dale/Time <br /> Method of Shipment ^, VOAJ OG AETAl OTHER Laboratory <br /> Special instructions IWO m <br /> I hereby aIli ze a pe mance of the above Indicated work <br /> GOOD CONDITION____ APPROPRIATE <br /> �7C M'Aii�ERS <br /> M. N1 <br />
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