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ARCHIVED REPORTS_XR0005717
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_XR0005717
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Entry Properties
Last modified
5/5/2020 3:02:21 PM
Creation date
5/5/2020 1:50:21 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005717
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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( Advanced CHAIN OF JCUSTODY RECORD <br /> m <br /> GeoEnvironental Inc zU��� `� Date l <br /> '� Page Of <br /> 637 Shaw Road - Stockton, California - 95215- (209)467-1006 - Fax (209) 467-1118 <br /> Chem <br /> Project Mana �r Tests Required <br /> � � t lc <br /> honetimber <br /> a <br /> ler„, (S nature) Invoice <br /> Project Name i / ` AGE <br /> J u Client ❑ <br /> G f <br /> Sample Location Sample Type <br /> Number Description <br /> Date Time Water ��► Solid Con sNo f Notes <br /> comp Grab <br /> 23 <br /> tI 2,5 <br /> W11t' -- -- / PRE 3ERVATION <br /> TI V APP 10PRIATE <br /> K,X SPACE ABSENP CO AINE1L <br /> MOLORINATED Irl LAB PRF SERVED IN L k8— <br /> f) <br /> leltnqFe <br /> i atur ecr) a acT y rgnature ate/Time <br /> Reltnq ,gnature) Received by (signature) 2 � � <br /> Dateffime <br /> Reltnqurshed by (Signature) Received by Mobile Laboratory for field analysts (Signature) DateMme <br /> Dispatched by (Signature) bate(Tlma ar aboratory by Qa eJTtme <br /> Method of Shipment � <br /> 6)Ue <br /> Lr_ Laboratoryme <br /> Special Instructions d I hereb , hori:e th pa formance of the above Indicated work <br /> /f ” <br /> ��A— <br /> K�h('4 <br />
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