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ARCHIVED REPORTS_XR0005432
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_XR0005432
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Entry Properties
Last modified
5/5/2020 2:54:09 PM
Creation date
5/5/2020 1:34:10 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005432
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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: <br /> Advanced CHAIN OF CUSTODACORD <br /> L� <br /> - GeoEnvironmental, Inc. Date 7 Page —L of <br /> T =" of Northern Calffornra <br /> 1603 West March Lane,Suite A Stockton California-95207 (209)956-0264-Fax(209)956-0700 <br /> h Project Manager <br /> Client )} <br /> ul�fd F i ��� 5t -� ; 1��� Tests Required <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> Project Name ff AGE <br /> F ti� i - '`� i t Client ] <br /> Sample Location Date Time Wa eple Type ater Solid No of `�t Notes <br /> Number Description Comp Grab Air Cants t <br /> k� <br /> XX\A\X,11 <br /> ''> 1xxx <br /> eli quis e by,(Sign tore) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Receive oralory by r D le/Time <br /> Method of Shi nt Laboratory tyame <br /> (� 1 <br /> _ l0 1rC inti � J i �1/t' i r' <br /> Special instructions I hereby authorize the performance of the above indicated work <br /> > 'GtiSe call --10 VEL <br />
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