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ARCHIVED REPORTS_XR0008059
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_XR0008059
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Entry Properties
Last modified
5/4/2020 3:43:41 PM
Creation date
5/4/2020 3:16:09 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008059
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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} <br /> Advanced CHAIN OF CUSTODY RECORD <br /> -�- GeoEnvironmental, Inc. c. ®c- Date 6 Page ( oi-1--- <br /> - <br /> 837 Shaw Road- Stockton, California-95215- (209) 467-1006- Fax (209)467-1118 <br /> Client Pra'e nagefi Tests Required <br /> P e Number <br /> r <br /> (p <br /> Sam : (Signature) Invoice: <br /> Project Name AGE ❑ <br /> k!a�', Client <br /> i Sample LocationSample Type � <br /> Number Description Date Time Water Solid N° °t Notes <br /> r <br /> Comp. (arab. Air Conts. i <br /> 7A5/./ /off 73.505 t <br /> 73506--... <br /> :` XJ Y <br /> 73508 <br /> F ! <br /> Helinquisned byjkmpurqwT atefr me <br /> Ade <br /> Relinquished by (RS' eceive -} , D eJTima <br /> -c <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field,analysis. (Signature) DateTrime <br /> Dispatched by: (Signature) Date/Time Received or Laporator byD elTime <br /> XZ7 <br /> I, Method of Shipment: Laboratory N me <br /> r <br /> Special instructions: i hereby ftorize the pefrforman a of the above Indicated work. <br /> I� <br /> A��- <br />
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