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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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CASTLE ANALY'TICAL LABORATORY - S CHAIN OF CUSTODY. <br /> Location 2333 Shuttle Dnve, Bldg 908/909, Atwater, CA 95301 Certificate No 2480 <br /> Madrng Address 2333 Shuttle Drive,Atwater CA 95301 PAGE OF <br /> Phone (209)384-2930 - Fax (209)384-1507 <br /> Customer REQUESTED ANALY ES Method of Shipment <br /> AddressL) v Cr <br /> city/.State/ZIPf " z <br /> �, � � � m � d Nates <br /> Phone FAX L1 ' Da U.Prof# P OPar ~ <br /> 0. tLj <br /> a V r, y <br /> Report Attention -77 a D z N <br /> Cd m <br /> n W <br /> Sampler Signature g q m w WZ X pi m <br /> Printed a <br /> d z <br /> Lab-W# SAMPLE ID DATE TIME DESCRIPTION/LOCATION tV - wIDOBSERVATIONSIREMARKS <br /> W t?� v i ✓Z Z . V y <br /> A- <br /> - . ' -� Y r r_ to 651gol 1N 31 <br /> w s. <br /> kiwir <br /> '- Wa Ll CL <br /> % a <br /> mivicam-mu, 59 <br /> r* 9111n S <br /> - YK <br /> a�.�a m msz r �" x F a i 3 x z a a lt a Ota number 0 containers submtted to <br /> y4' - tie tr '�rIle *1 �I8e A �1 , 1j 4O� ���C#i,� the laboratory <br /> Relinquished byZIA 4 j r -7 V'C + Note All special requests (e g <br /> Received by 1 Z 1 ` ' -C- t 1 t ZM, 1 `. +�- il: )'yl fq — quick turn tames)must be cleared <br /> through authorized laboratory <br /> Relinquished4y personnel <br /> ecerved by <br /> Relinquished by RESULTS DUE <br /> Received by VERBAL wRITFEN <br /> - k„--- fir`-e C 0 i�"4ct <br /> I <br />
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