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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
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LSauers
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EHD - Public
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t� �� tits ss t>.sw st■ tfi• Ifi, f� e>• il• i1• � � � � � � � <br /> Advanced CHAIN OF CUSTODY ECORD <br /> GeoEnvironmental, Inc Date G1" "`�� Page �� <br /> 937 Shaw Road- Stockton, California- 95215-(209)467-1006 - Fax (209)467-1119 <br /> Client Cir Project Manager <br /> Tests Required <br /> Phone Number <br /> q67 IoNo . <br /> Sa lers (Signature) )"voice <br /> Project Name J X AGE J!3� <br /> �C-C, I AJ Client E]Sample Location Sample Type No of d/ <br /> Number Description Date Time ComAir <br /> Air Solid Coats v Notes <br /> p GrabIv,W17 1 Z- 3 µw OC, t'I-Y.So 135 . <br /> µW14a it N•'"f ifY-C� It <br /> rL.WfYg rr ���,,IILI tt 1617191 A LLx/w <br /> l <br /> mfg fAk `? C- <br /> it I � <br /> Re ui3hed by ( ignatuf Received by (Signature) DatelTime <br /> 'd pl-_"-� �Ts t"` y-- �- <br /> Relinquished by {signature) Received b Si r ~J <br /> Y (Signature)) DatelTime <br /> /Z ZY (5..3/'�''5 <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis ature) Date/Time <br /> Dispatched by (Signature) Date/Time eceived or eab,-ora ry y 2 L Mate/Time <br /> U-11 <br /> Method of Shipment z o tory Nam <br /> 61 civ ���f/� u� t j ", l <br /> Spacial Instructions \tet �/ there uthortze the performance of the above indicated work <br /> l <br />
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