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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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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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x <br /> _rte � � eten� �� ttttttttttt� tttttttttttt■ � � ti � � � � � � i <br /> CHAIN OF USTODRECORD <br /> � Advanced � � <br /> GeoEnvironmental, Inc. (218S– Date ,/O-(—Page <br /> pf <br /> 837 Shaw Road -Stockton, California-95215- (209) 467-1006- Fax (209) 467-1118 <br /> Client Pr ect nager <br /> Tests Required <br /> P ne N tuber / <br /> f <br /> Samp rs (Signature) Invoice <br /> Project Name 9 QZ AGE +!�/ <br /> ro IeA Client ❑ <br /> Sample Location Sample Type <br /> Number Description <br /> Date Time Water Air Solid Coats Notes <br /> comp Grab <br /> p yl yFe 1 <br /> 17/t l��:rf�l1 r' f I <br /> 07 <br /> e rnqi e y gnatur f ece ve y gnature ateltime <br /> it <br /> Relinqurshe by (Signature) Received by (Signature) Date[Tlme <br /> Relinquished by (Signature) Received by Mobile Laboratory for held analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time isR v d r Lsborator <br /> D te/Ttme <br /> 252 <br /> Method of Shipment ,, Lalary ame <br /> L <br /> Special Insttucttons VI hereby authorize the p rf rmanre of this above indicated work <br />
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