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ARCHIVED REPORTS_XR0005715
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_XR0005715
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Entry Properties
Last modified
5/5/2020 2:33:52 PM
Creation date
5/5/2020 1:48:58 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005715
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 • <br /> CASTLE ANALYTICAL LABORATORY S 3t1CHAIN OF CUSTODY <br /> Location 2333 Shuttle Drive, Bldg 9081909, Atwater, CA 95301 Certificate No N79 <br /> Mailing Address 2333 Shuttle Drive, )%twater, CA 95301 PAGE__4_OF <br /> Phone (209) 384-2930 - Fax (209) 384-1507 <br /> Customer th." 6"chvivor7enw, Fnc • _44List q M70--so, I, " ' Method of Shipment L 1 <br /> Address q ply st7✓1 �- tl m I'! <br /> City/State/ZIP `� N w <br /> 8 w J a Notes <br /> Phone 1 FAX p — iQ 1.0� -- I sn <br /> Pro) # fes' m IL <br /> S D© Q <br /> Report Attention ^TI m GU e W s = a o <br /> Sampler Signature a V1 m <br /> Printed a D <br /> Q z <br /> v L b 1D# SAMPLE ID DATE. TIME DESCRIPT1ON&OCATiOI1t OBSERVATIONS/REMARKS <br /> WW— 238890 <br /> r 38891 <br /> y a _ MW— , <br /> 38892 <br /> 70 <br /> f r + <br /> 38893 1 <br /> 38e94 ' <br /> 38895 w2 <br /> ,1 y <br /> c 5s z <br /> x r _ <br /> i � s <br /> C <br /> T Ik <br /> I t�j hF` � fhi <br /> 1 ; <br /> * 5, r -- Y.M1_y�„F R S y� , /f�a�rtRx 1 ,J vI gA,_z F k”' olal number of wrttafners submitted to <br /> 'E i I. — ,TIhrcr1 . x11{ * h ° .e � ,�{1dfmh, r1,+.�fFex�'�D�I�e�s�.�'y;ra>" <br /> the laboratory <br /> Relinquished by dl <br /> Not,;-All special requests(e g quick&& 6 tj ra.Wic 4L6E44 4 <br /> Received by r tum times)must be cleared through <br /> Relinquished by <br /> authorized laboratory personnel <br /> Received 6y <br /> Rettmkutshed by <br /> s RESULTS DUE <br /> Received by 1 i s_ _ <br /> VERBAL VMI <br /> V. <br /> Iia.. /4i r �..� J«I'� r,�•ku+ �'J �k'4 �s� 1. kr <br /> 7 <br /> S <br />
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