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ARCHIVED REPORTS_XR0007951
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_XR0007951
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Entry Properties
Last modified
5/4/2020 3:55:39 PM
Creation date
5/4/2020 3:13:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007951
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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...�■ �� w� rs tip ttttrf�■� ttitiittitt! titiitiii� f� f� 1=11 1♦ 1c � <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc Date 07-30-94 page --L of <br /> of Northem Calrfonua <br /> 1803 West March Lane Suite A-Stockton California-95207 (209)956-0264-Fax(209)956-0700 <br /> Client Pr�c Tests Required uired <br /> 1 ,Pox ci� q <br /> Phone Number <br /> — 95k _ CZ04 <br /> Samplers (Signature) Invoice <br /> Project Name AGE <br /> Client p <br /> Sample Location Date Time Sample Type i No of Nates <br /> Number Description Water Air Conts <br /> Comp Grab <br /> 3v o45 <br /> Suoq.y <br /> 3. 3.0 )C I-L <br /> Aabzt 0 <br /> 1< 7� TrJ G L <br /> vf R.V�A I Q�__L[L <br /> Rau'quts e y (Signature) Received y ( ignature) --r Date/Time <br /> 41var4RrJ t� 9-114 F QJL�---Z <br /> Relinquishe y gnature) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysts (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Received r orator y /, DatelTtme <br /> Method of Shipment _ Laboratory Name <br /> Gr❑} ns rNk o t CAS-1 If, h1�y-�-t,CL% <br /> Special Instructions Ly 14-K I hereby authorize the perfotmance of the above indicated work <br /> Run on7'o ,1 LCA_Q__..Jn.� P -�4r�-� n <br />
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