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ARCHIVED REPORTS_XR0008087
Environmental Health - Public
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EHD Program Facility Records by Street Name
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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_XR0008087
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Entry Properties
Last modified
5/4/2020 3:50:11 PM
Creation date
5/4/2020 3:23:13 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008087
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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0 <br /> � Advanced <br /> CHAIN O CUSTODACORD <br /> -_ GeoEnvironmental, Inc Die G� Page 3 aft <br /> 837 Shaw Road- Stockton California- 95215 - (209)467-1006- Fax (209) 467-1118 <br /> Client _ Project Manager <br /> e—VTests Required <br /> P ne Nu be � <br /> �] <br /> Samplers (Signature) Irnroice <br /> AGE <br /> Project Na P PG -yam Obo, 3 - Client ❑ <br /> Sample Location <br /> Sample ype <br /> No of <br /> Number Description Date Time Water Air Solid Conts �N Notes <br /> Comp Grab <br />� ( �� X8 3 6 ��( VY-( 2 <br /> G G 14 �` <br /> A4J�q �AW L <br /> ( ��� l� <br /> Li�`@ k-F- <br /> Aw <br /> �� k-L � <br /> P-10 IC,-B � � CIR t2-13 <br /> �5 L V, lz-qc) <br /> e i quis e y rgnaturel aceIve d 5 y 79 rgnature F DatefTrm <br /> Va?11 <br /> Relinquished by ignature) Received by (Signature) 'iffatefrime <br /> Relinquished by (Signature) Received by Mobile Laboratory for tread analysis (Signature) Datef ime <br /> Dispatched by (Signature) DatelTrme Received for Laboratory b DatefTim - <br /> Method of Shipment Labor Name V <br /> f Ilia above indicated work <br /> Special Instructions 1 hereby thorize the erlor a coo <br />
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