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ARCHIVED REPORTS_XR0007414
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_XR0007414
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Entry Properties
Last modified
11/27/2019 11:35:17 AM
Creation date
11/27/2019 11:20:08 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007414
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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Phone(916 2110 APR 3 1991 �� Send results <br /> nmenfral Consultants Inc. ► Environmental <br /> FAX (916)78b-7$3{; AEGIS Enviro , � Aegis <br /> m le Identification/Field Chain of Custody 8U1 Riverside,Suite cENVIRONMENTAL HEAL� Record Roseville,CA 95678PERMIT/SERVICES <br /> For Shell Projects Only <br /> site Address O31 acr.f►'c S lekW 6L. WIC <br /> AEGIS Project# 90---oy AFE <br /> Shipped By lvle-r CT/DL <br /> Shipped To YJ 7r Shell Engineer: <br /> Project Manager el /Ca wee-z— Hazardous Materials Suspected9 (yes/no) <br /> Sampling Sample No.of Analysis <br /> Point Location Field ID# Date TVDO Containers Required <br /> �B�c�r b C�vy. /I�y� Sa,bl s ,�-.. TF5, 8T <br /> �r�s o � i�r�s <br /> A-t 8+C-t <br /> TV N- 6:.5 8 mr / <br /> 1\ V-- (4te-tc�D) VA rptt '5., a rr-�r lei <br /> (A P-}e-tv) NNy- rn#-- 64, 8 reX, Ie <br /> S a �s t, So,'' �� ( B-tCt�t �� S TPµ &s, BTex; �s�l <br /> 7 <br /> Sampler(s)(signature) <br /> Field ID Relinquished By(signature) Received By(signature) DatelTime Comments <br /> Ste- GL(,'dam L/ <br /> Sealed for shipment by (signature) Datefrime Shipment Method <br /> Received for Lab by (signature)_ -�� Datef rime Comments a r'a /► _ <br /> /;'�� liceorA � k 1p S `cis <br /> d"47(04 <br /> Receiving Laboratory: Please return original form after signing for receipt o samples. <br /> Whnc/Onpinal Ycllowli ah Copy PInkA fle Copy - <br />
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