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ARCHIVED REPORTS_XR0005583
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_XR0005583
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Entry Properties
Last modified
5/5/2020 2:18:04 PM
Creation date
5/5/2020 1:41:24 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005583
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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� aartttaa esr s� ttitiw ttliliii� ttfi � � � � � � � <br /> Advanced <br /> CHAIN OF CUSTODRECORD <br /> i <br /> GeoEnviranmental, Inc. Date Page of <br /> 837 Shaw Road - Stockton, California-95215 - (209) 467-1006 - Fax (209)467-1118 O _ �y 0 <br /> Client Project Mana er C w <br /> �� Tests Required <br /> I <br /> P one N mber <br /> 06 <br /> Samplers (Signature) Invoice <br /> Project Name�.� l AGE <br /> kite i� J� L Client ❑ <br /> Sample Type <br /> Sample Location No of �� <br /> Number Description Date Time Water Air solid Conts Notes <br /> Comp Grab <br /> A- <br /> of 0 <br /> Re in us e y ( nature) Received 6y79ig-na-t-u-r-eT- at (rime <br /> Relinquished by ignature) Received by (Signature) DateJ I I e <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) �\AT— Date(Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Date(Time �Q <br /> IUAj,.e ` !J"` <br /> Method of Shipment Laborat Name <br /> n. i( <br /> special Instfuctions , tf� � f J I hereby authorize the performance of the above indicated work <br /> //� `f(/ <br />
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