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ARCHIVED REPORTS_XR0005443
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_XR0005443
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Entry Properties
Last modified
5/5/2020 2:30:44 PM
Creation date
5/5/2020 1:39:29 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005443
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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r wr v �r ititititir .r ttiir t■r rr rr � ff... .� .•.. .... <br /> • CHAIN OF CUSTODY*CORD <br /> Advanced 3 <br /> GeoEnvironmental Inc. Date Page 4— of <br /> 4005 North Wdson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 <br /> Client Q 5Q Pro]erct Mana er J <br /> ! VC I A& <br /> Tests Required <br /> Phone Number <br /> Samplers (Signature) w Invoice <br /> A <br /> Protect Name r -E Client E]0 <br /> Sample Type <br /> Sample Location Date Time Water Solid No of Notes <br /> Number Description Comp Grab Air Conts <br /> 6RR55 <br /> C nl tt � E -08 J <br />'AW to ^ o V% F-k L4 R '55 <br /> Mwr�, - ;; rr .• rr <br /> It SI-IJ <br /> I <br /> 5r/ ' iJ <br /> Mv�� -;5 G <br /> M w l O " o �; r .., Vo art t <br /> ,u orinaj w' <br /> mw ii- sfl e c c r So I <br /> inquis a ( i nat re) leceived by ignature 'S1 AnDARflDate/Time <br /> oyn 7- / 3' 30 <br /> Relinquished by (Signature) Received by (Signature) DatetTi <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date rime <br /> Dispatched by (Signature) Date/Time Receive !or Laborator y DatetTime <br /> Method of Shipment Labora ry Name <br /> Special Instructions I hereby au arize the erformance of the above indicated work <br /> nor <br /> V V'� <br />
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