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ARCHIVED REPORTS_XR0008054
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_XR0008054
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Entry Properties
Last modified
5/4/2020 3:58:22 PM
Creation date
5/4/2020 3:14:50 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008054
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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r L 1 it k' ! Ir I r r <br /> a CHAIN OF CUSTOD`�I ,.�� <br /> C ecoR <br /> Advanced Date / <br /> Page _ � of <br /> GeoEnvironmental, Inc. <br /> 837 Shaw Road - Stockton, California- 95215 - (209) 467 1QQ6 - tax (209) 487 1118 <br /> Project Mana er <br /> Tests Required <br /> Client - � <br /> P e Number <br /> Sam p s: ignature) Invoice. <br /> AGE <br /> Project Name Client�� ` � <br /> Sample Type No. of . � <br /> Location <br /> Date Time Water Solid Notes <br /> Number <br /> Sample Description Camp, crab. Air Conts. <br /> - <br /> 90535 <br /> q r _02 90530 <br /> �} z-f --a <br /> 10 <br /> 90537 <br /> lug D z � - <br /> 90538 <br /> ecerve y: ignature ❑ em e <br /> e inq i e (Si nature <br /> ReceiGy $ S ate ime <br /> Relinquished by: (Signature VV��JJ jj� <br /> y for field analysis:(Signature) Date1'rime <br /> Relinquished by; ure M s !. 11l C <br /> .`�.} '^ ' ✓ Datefrime Received for Laboratory by' <br /> ! /rlmB <br /> Dispatched by: (Si$LpEYIi�lY — in . ©v'! <br /> f <br /> Laboratory Nam <br /> Method of shipment: <br /> i hereby authorize She pert rmaFlGe of the above indicated work. <br /> Special tnstructigns: -G C PAI <br />
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