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ARCHIVED REPORTS_XR0009067
Environmental Health - Public
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EHD Program Facility Records by Street Name
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N
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99 (STATE ROUTE 99)
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25355
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2900 - Site Mitigation Program
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PR0508370
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ARCHIVED REPORTS_XR0009067
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Entry Properties
Last modified
11/19/2024 1:50:33 PM
Creation date
4/1/2020 2:06:31 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0009067
RECORD_ID
PR0508370
PE
2950
FACILITY_ID
FA0008045
FACILITY_NAME
PACIFIC AUTO CENTER
STREET_NUMBER
25355
Direction
N
STREET_NAME
STATE ROUTE 99
City
ACAMPO
Zip
95220
CURRENT_STATUS
01
SITE_LOCATION
25355 N HWY 99
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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� ffffftftf■ � t� f1♦ � � � � a• � � � � � � <br /> i <br /> � Advanced <br /> CHAIN OF CUSTOAECORD <br /> -=- GeoEnvironmental, Inc. Date &-W-Vs Page —_ of--- <br /> 837 Shaw Road-Stockton, California-95215-(209)467-1006- Fax (209)487-1118 <br /> Client Nk---e. <br /> Project Manager <br /> Tests Required <br /> Phone Number <br /> czz�-t) gLc-1 - 1 $ <br /> Samplers (Signature) Invoice. <br /> Project Name ��c �r , _. r L a AGE <br /> Clier>t ❑ <br /> Sample Type 4 <br /> Sample Location Date Time Water Solid No of Notes <br /> Number Description Comp Grab Air Conts <br /> KW4-S ,k.W-q °' 64-015 015k 1W <br /> kw y-tQ 1� C w-i <br /> "L .-1S 11 -t C'f Oct t� <br /> KW ik--LO 1` Ink,� Dili <br /> KW LW - ; �( a. 2Gr 0q3Z <br /> KW t-:65 it a 35� 015S <br /> el+nquis e y (sig <br /> nature) ecerve y ignature Dateff" e <br /> �L ' 6-2.6w05 SpC� <br /> Refid4pished by (Signature) Received by (Signature) Daterrime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) I ` t Date(Time <br /> Dispatched by (Signature) Date/time Received for Laboratory by Dat PTme <br /> Method of Shipment Laboratory Name <br /> C�L.Tp--c-t-( <br /> Special InstfUCt+OnS 1 hereby authorize the performance of the above indicated work <br />
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