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ARCHIVED REPORTS_XR0005722
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_XR0005722
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Entry Properties
Last modified
5/5/2020 2:57:01 PM
Creation date
5/5/2020 1:53:50 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005722
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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111 � � r� ■� � � !• � � � � ti t� � � #� � <br /> ( Advanced CHAIN OF CUSTOD RECORD <br /> GeoEnvironmental, Inc. Date dZ Page ---L of <br /> 837 Shaw Road - Stockton, California- 95215-(209)467-1006- Fax(209)467-1118 <br /> Client Project Managpr <br /> Tests Required <br /> P one Number <br /> ;I&ef 00 r <br /> • . ._ <br /> Z--'7o6,5-6 Sampers (Signature) h Invoice <br /> Project Name AGE .F ' <br /> D Client ❑ <br /> Sample Location Sample aNo of <br /> Date Time Comp Grab Water Solid Notes <br /> Number Description Air Conts <br /> M 0 //6VO-.20-cl. "J.-.2-9/,o 3c, wo <br /> 1A <br /> x -- � <br /> 044) 5 11 X A4Cx7 <br /> Rol' s a ig ature ecei e y ignature <br /> D telTime <br /> ie <br /> Rall q by Signature)14 Received by (Signature) Date/Time <br /> R shed by (Signature) Received by Mobile Laboratory for field analysis (Signature) Datel"rime <br /> Dispatched by (Signature) DatelTime eived r Laboratory D e/Trme <br /> G 3�. <br /> Method of Shipment i t aboratory 7ne/1 , <br /> t! <br /> Special Instructions I hereby authorize the rf rmance of the above indicated work <br /> C <br />
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