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ARCHIVED REPORTS_XR0007944
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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4405
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2900 - Site Mitigation Program
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PR0542364
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ARCHIVED REPORTS_XR0007944
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Entry Properties
Last modified
5/4/2020 3:47:18 PM
Creation date
5/4/2020 3:12:31 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007944
RECORD_ID
PR0542364
PE
2960
FACILITY_ID
FA0024340
FACILITY_NAME
PACIFIC CAR WASH
STREET_NUMBER
4405
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
11024014
CURRENT_STATUS
01
SITE_LOCATION
4405 PACIFIC AVE
P_LOCATION
01
QC Status
Approved
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LSauers
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EHD - Public
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i i�i i i i i � l• � � l� I� I� tttltllllll■� fIIItIII� <br /> CASTLE ANALYTICAL LABORATORY /G<cZ CHAIN OF CUSTODY <br /> Location 2333 Shuttle Drive, Bldg 9031909, Atwater CA 95301 Certificate No 2079 <br /> Mailing Address 2333 Shuttle Drive Atwater, CA 95301 PAGE_ OF <br /> Phone (2091 384 2930 - Fax (209) 384 1507 <br /> Customer - j I` '/ REQUESTED ANALYSES Method of Shipment <br /> Address �s p I ► G ) M v v w (1,4- <br /> ED <br /> City/State/ZIP 5 jjjC/�/-���jT �[J � N o 2 iN <br /> Notes <br /> Phone 1 FAX _ 0209 �/� 7-�C (v Ci J �> 7- / w p � w W > o <br /> Prod # IPO # �CcI iCJ CL -i ~ o <br /> Report Attention �M r " u. $ a u a cc \ a <br /> E Cl) _ ca <br /> Sampler Signature N m V 1:0 <br /> D <br /> Printed o Z <br /> jiLab IDI# SAMPLE ID DATE TIME DESCRIPTION/LOCATION tk 06SERVATIONS/REMARKS <br /> i <br /> ZS� r �85964 a <br /> f rrr 1- ti y� _`M966 <br /> 0I III(--qZ2 Z lo r Z r <br /> 85 <br /> 4966 t <br /> z <br /> Hie-( <br /> r 85967 <br /> 1 <br /> 85968 _ �I <br /> VQAS I&IJIii TAL FH 85969-' ' <br /> 7f) , , .t► I A P 71,e lila E <br /> HEM,") jiuJ I I UUNIWNLK�--It— <br /> rtxj/ /-,& e" �- T' <br /> t -vY tga EM g - <br /> Total number of containers submitted to <br /> a e / Printed Name Date Time Company Name the laboratory <br /> Relinquished by L'L L �J l� 2 / - f�` G U 7 / — Note All special requests{e g quick <br /> �lturn times)must be cleared through <br /> Received by GJ /� A?i ' �' -`! rmi-Well tit abiauthorized laboratory personnel <br /> Relinquished by <br /> Received by <br /> Relinquished by RESULTS DUE <br /> VERBAL WRITTEN <br /> Received by <br />
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