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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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i <br /> CASTLE ANALYTICAL LABORATORY <br /> CHAIN OF CUSTODY ' <br /> Certificate No 2079 f 11 <br /> Location Castle Air Park, Bldg 909, Atwater, CA 95301 PAGE OF <br /> Phone (209) 3B4 2930 - Fax 1209) 384-1507 REQUESTED ANALYSES Method 01 SFupment <br /> t • , l s e <br /> Fdroe <br /> er u O YYl'1,r+ `1..�- �w� s Q Cr �1U.+�l Ll L£ t <br /> . 2 �.�+ .t'��.�-'- —4 - a � Jn` a Notes <br /> te/ZlP a�-, .r o U FAX (, : c 3- 'y`- a 7 z w U <br /> Pro) # /P D ;R< a o <br /> � l i ' r,} °7 � Qa F0.- r <br /> Report Attention r 0. �,.8m ` ID <br /> Sampler Signature _ z <br /> Printed OBSERVATIONSMEMARKS <br /> I.Ap IN SAMPLE ID DATE TIME DESCWPTIONILOCATION <br /> 7otat number o4 mntamm sabmtt ed tv <br /> Date Time Company Name the iaba" <br /> f� ture Printed Name — Note All special requess,(a g quick <br /> el,nquished byf (Wn Gmes)must be cleared Through <br /> authorized laboratory Ptrsonnel <br /> Received by. <br /> Rehrr4uished by ` iL� <br /> Ftecervod by RESULTS DUE <br /> Rnl�nquished bW VERBAL V RMN <br /> Reoeived bV <br />
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