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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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EHD - Public
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-- Advanced CHAIIN OF <br /> CUSTODY�ECORD <br /> -, <br /> GeoEnvl�onmental, Inc. Dater Page ,� ot� <br /> of Nortlt��nt Caltfonuu <br /> 1803 West March Lane,Sude A Stockton, California-95207-(209)956-0264-Fax(209)956-0700 <br /> Client <br /> O 4,Z I' R Project Manager 5o Tests Required <br /> V,";" C e I lop, <br /> Phone Number <br /> - 0 V <br /> Samplers (Signature) Invoice <br /> Project Name ,/� AGE <br /> 7 Client L:] <br /> Sample Location Sample Type No of ' <br /> Number Description <br /> Date Time Water Air Solid Conts Notes <br /> Mp�i r1^� LUQI� � <br /> Comp Grab <br /> IVrW � �✓ , <br /> 91 <br /> 91 <br /> Kelm Is e y (Signature) eceived by ( Ignature) S7�4N D11 R 4 Date/Ttme <br /> /yam 7p p, J —, r <br /> On <br /> Relinquished by (Signature) Received by (Signature) DatetT me <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Dale/Time <br /> Dispatched by (Signature) Date/Time stew d for Labora ory by / COate/Timet <br /> .1-4 'T 6 ti <br /> Method of Shipment Liboratory Name <br /> J <br /> £krvi t j u <br /> Specialplmx <br /> structtons 1 I herebyauthorize the <br /> CCI�� 4 1A9, performance of the above Indicated work <br />
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