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ARCHIVED REPORTS_XR0005438
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_XR0005438
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Entry Properties
Last modified
5/5/2020 2:09:54 PM
Creation date
5/5/2020 1:37:01 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005438
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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�• *Advanced <br /> • CHAIN OF CUSTOD'�ECORD <br /> -= ` GeoEnvironmental, Inc Date Page of <br /> 4005 North Wilson Wa Stockton California-95205 209 467 1006-Fax 209 467-1118 <br /> Project rol` ect Manager <br /> -- rE64 <br /> _ f Tests Required <br /> Phone Number <br /> a� - - t �A <br /> Samplers (Signature) Invoice <br /> 4'3E,< <br /> Project Name L �_ u Client p <br /> Sample Location Sample Type Noof <br /> Number Description comp <br /> Time Water Air Solid Conts `V Notes <br /> comp Grab <br /> 1_I .1 .L <br /> N 9m X <br /> Mw- 2 '.� �14 <br /> �j XN <br /> e rnqu5s e y nature) Received by -(Signature) at me <br /> Relinquished by (Signature) JReceived by (Signature) D e(Trme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatelTrme <br /> Dispatched by (Signature) Date/Time 1e :Zvedrl � ate rme <br /> Method of Shipment t Laboratory Narms <br /> &SW F <br /> Special tnstruetrons I hereby authorize the performance of the above indicated work <br /> L` fr <br />
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