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ARCHIVED REPORTS_XR0008092
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_XR0008092
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Entry Properties
Last modified
5/4/2020 3:46:25 PM
Creation date
5/4/2020 3:27:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008092
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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Advanced CHAIN OF CUSTOD %ECORD <br /> � <br /> -- -_ ; GeoEnvironmental, Inc. Date '7-g 3 Page --2—of <br /> 837 Shaw Road - Stockton, California-95215- (209)467-1006- Fax(209)467-1118 /n <br /> Project Manager <br /> Client 'rte�' �c� — — Q u � I/ Tests Required <br /> Phone Number <br /> 'IC, 7 - iccro- <br /> Samplers (Signature) Involce <br /> �Q AGE � <br /> Project Name r r Client5 r4 6;� "t'� ❑ <br /> 4 <br /> Sample Location <br /> Sample Type <br /> Sam No of Zr � .� <br /> p Date rime Water Solid q '` u Notes <br /> Number DescriptionAir Conts J` <br /> Comp Grab <br /> ID;%t ~I w�l� le 7' C* <br /> (' ra E'l'A� I C" ' ��4/� Y` ��\� X / s/ S <br /> t t � + i <br /> KJ 14 ' I. far _�✓�' ��5� � A/ 1 <br /> TI -71- <br /> e in s e y ( gnat ure ecerva y igna(ure DatalTtme <br /> Re rnquished by (S+gnature) Received by (Signature) DatslTime <br /> Relrnquwshed by (S19nature) Received by Mobile Laboratory for field analysis (Signature) Date(Trme <br /> Dispatched by (Signature) DatelTime Re ed r Laboratory by Dat ime <br /> Method of Shipment .— Le rat 7a, <br /> &� <br /> S acral Instructions i� j 1 hereby uthorize the perform ce of the above Indicated work <br /> Pj a is 1U t D Nta tee. b Oxo Wti� <br />
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