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ARCHIVED REPORTS_XR0008072
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_XR0008072
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Entry Properties
Last modified
5/4/2020 3:54:47 PM
Creation date
5/4/2020 3:19:00 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008072
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
Scanner
LSauers
Tags
EHD - Public
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( Advanced CHAIN OF CUSTOD *CORD <br /> GeoEnvironmental, Inc. Date Page of <br /> 837 Shaw Road - Stockton, California- 95215-(209)467-1006 - Fax (209)467-1118 <br /> Cl1ent S �` Proi wMarrlu e,i ager l a r Tests Required��.. <br /> Prone Number <br /> Samplers (Signature) Invoice <br /> Project Name y AGE <br /> CLC- Client ❑ <br /> t� <br /> Sample LocationSample Type <br /> Date Time Water Solid No of �+ �� 5 N Notes <br /> Number Description <br /> + Camp Grab Alf COf1tS <br /> JwW�f !I Z(Gas �� i� � '� � �r �� ✓ <br /> tux l <br /> ikw iu� it µw 1a A 610 <br /> ioa " fig d r+ 0755) <br /> 7- <br /> M IV 1:3g lute 3A ti 070S 1 0 <br /> Re uifthe y ignature) eceive y ignature <br /> Datefrime <br /> �IlWnquished by (Signature) Received by (Signature) Date/Time <br /> le a" �� /64 <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysr {Sr nature) Date/Time <br /> lr... r <br /> Dispatched by (Signature) Dale/Time Rew d t Lab ato y by telTime <br /> I` <br /> Method of Shipmentaz <br /> s o ary Name <br /> taI'ti s / 4 e, <br /> Special Instructions ���, �� I here authorize the perforinance of the above Indicated work <br />
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