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ARCHIVED REPORTS_XR0009091
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_XR0009091
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Entry Properties
Last modified
11/19/2024 1:50:33 PM
Creation date
4/1/2020 2:10:28 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0009091
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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L <br /> Advanced CHAIN OF CUSTODPRECORD <br /> GeoEnvironmental, Inc. Qate -" Page -A— of <br /> 837 Shaw Road - Stockton,California- 95215 - (209)467 1006 - Fax (209)467-1118 <br /> Client Pr ct Magage Tn Required <br /> 1PP we Number <br /> s ( nature Invoice <br /> Project Name AGE <br /> pot,, [ Client ❑ <br /> Sample Location Date Time :sample TypeWater Solid No of Notes <br /> Number Description comp arab Air Conts <br /> ✓OVTM <br /> 4 <br /> } <br /> U L :' I, <br /> 1-7 <br /> PR RV l0, <br /> It �,!��k'it�,-�,U (ii7 UPJ �li�t.�S ✓ <br /> N in 1 e y (Sig ece ve y (Signature) i 3 j D j telTime <br /> 2 4 <br /> Relinquished by (Slonat e) Received by (Signature) InatefTime <br /> Refinquished by (Signature) Received by Mobile Laboratory for field anslyaia (Signature) OatelTime <br /> Dispatched by (Signature) Date/Time aGeived for I n oratory by rlate[Time <br /> Method of Shipment f Laboiatory N no <br /> ktw <br /> Special tnstructtons i hereby of#earl a the rl rmance of is above lndioated work <br />
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