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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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�.� ,..wa� �n ■w �� �� wt� sir t� �� �� �� �� t� � ■� � � <br /> CASTLE ANALYTICAL LABORATORY �ooao XAGE3SoL CHAIN OF CUSTODY <br /> Location 2333 Shuttle Drive, Bldg 908/909, Atwater, CA 95301 Certificate No 2079 <br /> Maiiing Address 2333 Shuttle Drive, Atwater, CA 95301 PAGE_ OF <br /> Phone (2091384-2930 Fax (2091384-1507 <br /> Customer _ REQUESTED ANALYSES Method of Shipment <br /> Address 920 5 Matt zi, 11 <br /> Cit /State/ZIP r VET-0 " x L w <br /> City/State/ZIP Veit, vs_ n, 0 +x 0 � z Notes <br /> a <br /> Phone / FAX ��U�� 7 _ l "*' w i <br /> Prod # / P O # P A C c�i� r a �, W Q a co o a o <br /> Report Attention —�L a a z LL <br /> as a <br /> Sampler Signature g in ~ ~ `� m <br /> Printed +an " z <br /> r� <br /> Lab ID# SAMPLE ID DAI E TIME DESCRIPTIONILOCATION '1G OBSERVATIO NSIR EM ARKS <br /> fjtk'W,, <br /> tr <br /> RtJ <br /> 0L.0 <br /> Yl <br /> vans ON CAI THER <br /> HESE VA W <br /> Inbit-)SPACE l tf <br /> J <br /> Total number of containers submitted to <br /> Signature Printed Name date Time Company Name Ihetaboratory <br /> Relinquished b _ i j{� Note All special requests(e g quick <br /> Received b lie, C�13 �,,�_y� IU �� U L i��L- turn limes)must be cleared through <br /> authorized laboratory personnel <br /> L <br /> ed by <br /> byhed byESULTS DUE <br /> by VERBAL. WRITTEN <br />
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