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ARCHIVED REPORTS_XR0005723
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_XR0005723
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Entry Properties
Last modified
5/5/2020 3:43:43 PM
Creation date
5/5/2020 1:54:27 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005723
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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LSauers
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EHD - Public
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i>�ai taf 0111111111111111111 <br /> ( Advanced CHAIN OF CUSTOD RECORD <br /> GeciEnvironmental, Inc. Date oZ Page --L of <br /> 837 Shaw Road- Slockton, California-95215- (209)467-1006 - Fax (209)467-1118 <br /> Client Project Manager <br /> !-C.� ---- Tests Required <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> Project Name � ', AG -511 <br /> E <br /> Sample Type Solid Client <br /> Sample Location Date Time No of <br /> Number Description Water Air Conts 1 Notes <br /> Comp Grab <br /> AUX) /AQ 341ero-L :L, <br /> fd iiov <br /> 4z&-0-J 5 <br /> -sem <br /> "u1 <br /> ° <br /> e ingws y Ig tur ) �9 ece ve y ignature Dale/Time <br /> R011ed by (Si ure) Received by (Signature) Dats/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) J Date/Ttme <br /> Dispatched by (Signature) Date/Time Recel d r or ory by Dai /Time/� <br /> 'z,�flU <br /> Method of Shipment oratory s <br /> v <br /> Special tnsttuct+ons I hereby authorize the performance of the above Indicated wor) <br />
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