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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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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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EHD - Public
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�.� � writ- rim ttttttt�r � tttttttitttitte : t� � � � ;_ � li � � <br /> Advanced CHAIN OF CUSTOD)WCORD <br /> L� <br /> GeoEnvironmental, Inc. Date S t{' L)-r 7 Page 2 03— <br /> of <br /> f-of Northern Calrfonuu <br /> 7803 West March Lane, Suite A-Stockton, California 95207-(249)956-0264 Fax(209)956-0700 <br /> CllentProject Manager <br /> Tests Required <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> Project NameCAL- F AGE fKCllent <br /> Sample Type <br /> Sample Location Date Time Water Solid No of Notes <br /> Number Description Comp Grab Air Conts \ <br /> Y�Nx I <br /> M�v ` Cr, Xx <br /> h <br /> eli�u� by ;gnatut Reoeived by ( ignature) � h �atelTime f ry <br /> Relinquished by (Sig t re) 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 Rec e)d r aborato b Dale Time <br /> Method of ZmentG <br /> �[r f 1' Laboratory Namef <br /> /Q Alald), " ) <br /> S ecial instructions I hereby authorize the performance of the above indicated work <br /> 1�rs rr��J 4� <br />
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