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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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LSauers
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EHD - Public
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!i � ii t� ■i t• � 1• i i i i i i i i i i � <br /> ( Advanced CHAIN PF PUSTODY R COR <br /> GeoEnvironmental, Inc nate Page <br /> 837 Shaw Road - Stockton, California- 95215 - (209)467-1006- Fax (209) 467-1118 <br /> Client Project Man er <br /> Tests Required <br /> Phone umber <br /> A67 <br /> Samp ers (51 ature) Invoice <br /> Project Name AGE <br /> Client ❑ <br /> Sample Location Sample Type No of <br /> Number Description Date Time Water Air Solid Conts Notes <br /> Comp Grab <br /> tom& <br /> Lc� K -9v <br /> e mquis Received by (signature) DatelTtme <br /> Relinquished by (Signature} Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Re ved f k Laboratory Date/Time <br /> Method of Shipment Laborato Name <br /> Special Instructions I hereby thorize th performance of the above indicated work <br />
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