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ARCHIVED REPORTS_XR0008186
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_XR0008186
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Entry Properties
Last modified
5/5/2020 3:20:31 PM
Creation date
5/5/2020 2:51:55 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008186
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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t� � i �/ � i i i � i i i i i i• i <br /> • F CUSTODRY <br /> RAIN O <br /> © � t C <br /> � Advanced <br /> GeoEnvironmental, Inc. <br /> Date ) ( Rage of Z <br /> 637 Shaw Road - Stockton, California 95215- (209)467 1006 Fax (209) 467-1118 <br /> Client ` Q — ProlT Manager <br /> ( � Tests Required <br /> honeurn r � <br /> 97- Loo co <br /> ,, <br /> a lers (Signat a Invoice <br /> Project NameX ' AGE <br /> r �(NFtcClient ❑ <br /> Sample Type <br /> Sample Location Date Time Water Solid No of Notes <br /> Number Description Comp Grab Air Conts <br /> eh uis nat ecetve y ignatute DatelTime <br /> Re fished by (Signature) Received by (Signature) Date(Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatelTime <br /> Dispatched by (Signature) DatelTime Receive r L oratory. DatelTime <br /> rl s a <br /> Method of Shipment Laboratory Name <br /> Special Instructions cc t I he authorize th ormance the above indicated work <br />
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