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ARCHIVED REPORTS_XR0005429
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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2402
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3500 - Local Oversight Program
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PR0545640
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ARCHIVED REPORTS_XR0005429
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Entry Properties
Last modified
5/5/2020 2:16:56 PM
Creation date
5/5/2020 1:32:26 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005429
RECORD_ID
PR0545640
PE
3528
FACILITY_ID
FA0003900
FACILITY_NAME
PACIFIC PRIDE COMMERCIAL FUEL
STREET_NUMBER
2402
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95204
APN
12506001
CURRENT_STATUS
02
SITE_LOCATION
2402 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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LSauers
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EHD - Public
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- F <br /> CASTL ANALYTICAL LABORATORY lag6SXk&e- � , o CHAIN o CUSTOP <br /> Location 2333 Shuttle Drive, Bldg 9081909 Atwater CA 95301 Certificate No 2079 <br /> Man,ng Address 2333 Shuttle Drive Atwater, CA 95301 PAGE OF <br /> Phone 1209? 384 2930 Fax (209) 384 1507 <br /> Customer AijkJ16 t(- t'd /�'f' t.l 111 f7JJ}111c'i1 L REQUESTED ANALYSES Method or Shipment <br /> Address qcn r2 W0 r`�L��ISO vk (tJc,s J m V v �' � CA -O Jf,,e�t t <br /> CrtylState/ZIP Ck- ,�, C S a N � a J y ��, Notes <br /> Phone ! FAX f2Lci��l�7 - I �G - { ,^ 4�7- i l 1 V a § a " (n m <br /> Prot # IPO # , w w ( 991, <br /> �-W 5 C1t � �3 <br /> Report Attention W � 14 C- w Q 2 ((���jj jjnn'�� QQ 4n/4'��� , <br /> J U) ro r-' ~ ~ L V W V ' <br /> Sampler Signature E U 0 m <br /> Printed <br /> Lab ID# SAMPLE ID DATE TIME DESCRIPTIONILOGATION l � OBSERVATIONSlREA+IARKS <br /> / r <br /> .� cr14 36 � � Q � ' <br /> r W ' Lu X BG 102 , <br /> 4 !U7Y x ' <br /> 10 31 ,6 hcc <br /> k � r <br /> q <br /> t , <br /> Total number of conlamers submitted to <br /> 1 nature Printed Name Date Time Company Name the laboratory <br /> 11 ZZY <br /> Relinquished by ^ ` f -(� 1 tit ; ~ Note All special requests(e g quick <br /> _ turn times)must be cleared through <br /> Received by IFAP r authorized laboratory personnel <br /> Relinqu,she by <br /> C � � <br /> Received by <br /> Relinquished by �'�1:s ''`4"'"``t _ Ark RESULTS DUE <br /> Received by ��►+i'- �uL}, I n .I X16 VERBAL WRITTEN <br />
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