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ARCHIVED REPORTS_XR0005714
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_XR0005714
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Entry Properties
Last modified
5/5/2020 2:31:09 PM
Creation date
5/5/2020 1:48:27 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005714
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 i • <br /> Advanced CHAIN OF CUSTODY RECORD <br /> --L Of <br /> --- GeoEnylronmental, Inc. , — ��� °ate Page <br /> 4005 North Wilson Way-Stockton,Calitomia-95205-(209)467-1006-Fax 208)467-1118 <br /> Client Pro ect Manager <br /> Tests Required <br /> P e N tuber <br /> � � l <br /> a s (S nature) Invoice <br /> ,/ <br /> Project Name r AGE <br /> �� Clien ❑ <br /> Sample Location Sample Type No of <br /> Number Description Date Time Water Aar Solid Conts Notes <br /> Comp Grab <br /> � �lS <br /> 43715 <br /> rf Syr s, SID a� 4371s <br /> X . rt1 <br /> LM <br /> Rehnqui y i n ture Received By ignature DatelTtme <br /> Rehnqut ed by (SignaffureT Received by (Signature) Datal7tme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysts (Signature) r� Date/Time <br /> s <br /> Dispatched by (Signature) Date/Time a ed for Laborftory by I DatetTime <br /> Method of Shipment /'1 � � Laboratory Na <br /> Speelai I strucuons y ! hereby a t rize th perfoirmance of the above indicated work <br /> t <br /> r, 0� <br />
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