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ARCHIVED REPORTS_XR0012609
Environmental Health - Public
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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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6131
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3500 - Local Oversight Program
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PR0545003
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ARCHIVED REPORTS_XR0012609
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Entry Properties
Last modified
11/27/2019 11:08:19 AM
Creation date
11/27/2019 11:00:41 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012609
RECORD_ID
PR0545003
PE
3526
FACILITY_ID
FA0002324
FACILITY_NAME
Pacific Service Station
STREET_NUMBER
6131
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
09746418
CURRENT_STATUS
02
SITE_LOCATION
6131 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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Phon <br /> FAX (916)786-783 AEGIS ]Environmental Consultants Inc. send resultsAegis FAX (916)786-78313 9 Aegis Environmental <br /> Sample IdentilicationlField..Chain of Custody Record 801 Riverside.Suite C <br /> Roseville,CAy 679 <br /> For Shell Projects Only <br /> Site Addnw. S L r �� l�kfj flG lrC/Q�� C�. W1C: Zai• 7!`2 <br /> AEG IS Project# QO- AFE: <br /> Shipped By- r f S Cr/DU <br /> Snipped la: to.bid'-- - Shell Engineer: <br /> Proj^ct Manager Alm H 6:W 6--,r Hazardous Materials Suspected?(yes/no) <br /> Sampling. Sample Pio.or Amilysis <br /> Point Location Field IM Date TvPe Containers Required <br /> 3/27/fa 50,M?4�„ Tp; <br /> Z. SSh�� 3/z7/�d A i rn/; To.qge3 9W <br /> / , <br /> UiJ <br /> ivy ��x <br /> 6dc/ l�S/7 �1a7/Sv '\ <br /> 6-5 V a' �{StaS �s/q ; ray Ery <br /> K4, -5fj7 1D 1'901 arr 7.111 <br /> �s� I/27/v rel{, & 7 <br /> Tek, treX n f. <br /> Samplers)(signature) <br /> Field ID Reran wished By(signature) f' Received 11 (si"nature) Daterrime Cutsments <br /> af./Yr Gd,-Ve ,�, nK /-az �/ �G% /lam' lV� <br /> � t' ✓�riflPrl <br /> Scaled-for sbipmcrtby:(signsture) 7r/ 1, 1 Dateflime: E ShipmentMelhod- (6ati•'( <br /> I 1I - l�—''A' <br /> �Receivedfor Lab by:(signature) + 0IL ,1) iLv" <br /> Comments: <br /> Receiving Laboratory: Pease return original.arm after signing for receipt of samples. <br /> l Whit c�*riginel YellowllabCopy t'ir k 1 <br />
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