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ARCHIVED REPORTS_XR0008076
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_XR0008076
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Entry Properties
Last modified
5/4/2020 3:50:24 PM
Creation date
5/4/2020 3:20:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008076
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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a <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental Inc. Date zs Page of <br /> 837 Shaw Road- Stoc,kton, California -95215- (209) 467-1006 - Fax (los) 467-1138 <br /> Client _ Project anage <br /> Tests Required <br /> P ane umber <br /> ampl (Signature) �'`� Invoice <br /> Project Name AGE �— <br /> Client [3 <br /> S€Imple4: Location Sample Type <br /> Date Time No of <br /> Number Description Water air Solid Conts '� Notes <br /> Com Grab .� <br /> Mtvdo -- 1Iao <br /> � Q 16L <br /> 10 <br /> AW 13A /,0 3010 <br /> u" <br /> it's e y { g MUM) ace ve y tgnaturaj <br /> Dal/�ITlme <br /> -we— quashed by {S3gnalur Received by (Signstura} _—'� <br /> atelTime <br /> 1ke13nqu1ahed by (Signature) Received by Mobile Laboratory for field anatyaia (Signature) ------ <br /> Qlspat-hed e. <br /> by {Signature} Qa1elTirne Received nr Laboratory y , Da /Time <br /> Method of Shipment Labnrato N me <br /> U <br /> Special instructions 4 � I hereby aut the pe mance of the above Indivated work <br />
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