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ARCHIVED REPORTS_XR0007947
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_XR0007947
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Entry Properties
Last modified
5/4/2020 3:51:13 PM
Creation date
5/4/2020 3:12:47 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007947
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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EHD - Public
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CASTLE ANALYTICAL LABORATORY _ xP6oLil qW9 CHAIN OF CUSTODY <br /> Location 2333 Shuttle Drive, Bldg 9081909, 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 A REQUESTED ANALYSES Method of Shipment <br /> Address v En <br /> City/State/ZIP N o (n 's z Notes <br /> Phone / FAX <br /> w z <br /> Prod # IPO # v x o .� O <br /> w <br /> a W b m V U <br /> J Q LL <br /> Report Attention a = a `� 0 1 , "- arxs' <br /> a E ai H FCr <br /> w lam.nr r� � K+_`ti <br /> Sampler Signature m u m i` � ,''tri f } <br /> Printed " ` z $�4 xr �t <br /> Y <br /> Lab ID# SAMPLE ID DATE TIME DESCRIPTIONILOCATION <br /> Uj(o•u15 <br /> r r <br /> 6 .3r <br /> IN 6" q5 -Si { t�`' ra " <br /> Am J <br /> kL � O �" <br /> -�, <br /> t <br /> Total number of containers submitted to <br /> Signature Printed Nanje Date Time Company Name the laboratory <br /> Relinquished b t S / 7el%f4 A14 <br /> ~ Note All special requests(e g quick <br /> n_ turn Mmes)must be cleared through <br /> Recerved by , 141C /�• �� cC 11 9 3 I t authorized laboratory personnel <br /> Reirnqurshe y <br /> Received by <br /> r <br /> Relinquished by666D Din 1 )APPROPRIATE RESULTS DUE <br /> Received by �, i VERBAL WRITTEN <br />
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