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ARCHIVED REPORTS_XR0008053
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_XR0008053
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Entry Properties
Last modified
5/4/2020 3:47:02 PM
Creation date
5/4/2020 3:14:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008053
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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tltt� �tttatttil t�tl flt� s � I�r fi>� � tifffff� �■■� � � 1� �qr � <br /> ( Advanced CHAIN OF CUSTODY RECORD <br /> L page �. of <br /> GeoEnvironmental, Inc. Date <br /> 837 Shaw Road - Stockton, California-95215- (209)467-1006- Fax(209)467-1118 <br /> Client <br /> Project Manager <br /> � � . <br /> Tim G,eJTests Required <br /> r- <br /> f, Phoone/fi] Num[b�e/r�-"7 <br /> OA 9 r �7L1� / !j <br /> 006 <br /> Sample (Signature) p� Invoice <br /> Project NameAGE�I i . � 0# Client p GiC i i t�r W k&� / 4 <br /> Sample Location Sa YPe No of <br /> Number Description Date Time Water Air Solid Conts ^ Notes <br /> Comp Grab <br /> 14if los J 40 L -0 L 13L17 <br /> Iw1Da/osiYoz s��+-oz cosi <br /> Iwteb/ r402 ��fti-oz104LJ <br /> I <br /> I <br /> RewqtChed (Signature ecerve y ignature Uate/Trme <br /> S-1 y--07, 116CQ <br /> nqOTshed by (Signature) Received by (Signature) Date(Trme <br /> I <br /> I <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatelTrms <br /> I <br /> Dispatched by (Signature) Date(Tlme Received to a rat by 0 JTmme <br /> I <br /> Method of Shipment Laboratory Name <br /> Special Instr c ions " I hereby a hor a the p rmance of the above indicated work <br /> i <br />
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