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ARCHIVED REPORTS_XR0008170
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_XR0008170
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Entry Properties
Last modified
5/5/2020 3:34:05 PM
Creation date
5/5/2020 2:44:16 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008170
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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7o-L� <br /> r Advanced CHAIN OF CUSTODPECORD <br /> 4 <br /> GeoEnvironmental Inc. Date 9-/0-9& Page o � <br /> of No r rc r it Ccrh jnr mct <br /> 1803 West March Lane Suite A Stockton California 95207 (209)956-0264 Fax(209)956 0700 <br /> Client ku 1,41 j NPre Pro (J na� r ` Tests Required <br /> Number <br /> ' I <br /> Samplers {Signature} Invoice <br /> AGE <br /> Project Name A a <br /> 6g �� Ch <br /> Solid ent <br /> Sample Location Sample Type No of ,�Q <br /> Number Description Date Time Water <br /> Comp Grab Air Conts Notes <br /> / f <br /> �-!a lo <br /> ehnqu ed.by (Signature) Received by (Signature) Da a/Time +, <br /> '911746 ��- <br /> e inquished by (Signature) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Receiv t ^Laboyetory by Dale/Time <br /> Method of Ship en t Laboratory Name <br /> G �p� <br /> Special InslrueUons 1 hereby authorize the pe4armance of the above indicated work <br /> �LCa <br />
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