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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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EHD - Public
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rrrrrrrrrrrrre � erai� � �� �s <br /> [ Advanced CHAIN OF CUSTOD RECORD <br /> - GeciEnvironmental, Inc. Date v v Page �- of—[� <br /> 837 Shaw Road- Stockton, California 95215- (209) 467-1006 - Fax209)467-1118 <br /> Client Project Manage n, po., P6 C <br /> Tests Required <br /> 7-Z-7 <br /> umber <br /> G <br /> S p ers Signature) Invoice <br /> Project Name � AGE <br /> p Client ❑ <br /> Sample Location Date Time Sample TypeWater Solid No of Notes <br /> Number Description comp (arab Air Conti <br /> s 1 88127 <br /> 88128 <br /> Roll nq s e rgn urs aoe ve y (Signature) aternme <br /> v 42 <br /> Relinquished by ( ignature) J Received by (Signature) OalalTlme <br /> Relinquished by (Signature) Received by Moll Laboratory for field analysis (Signature) Dataffirne <br /> Dispatched by (Signature) Data Time Received for Laboratory by DatolTime <br /> Y4V €3 /u.6' 01/0 2 R-3-0 <br /> Method of Shipment Laboratory Name <br /> Special Instructions DDS 1141 tTAfr np I hareb uthorI t e perfor ance of tAa above Indicated work <br /> Col !tJ [1fYU 11 LJ Ir, <br /> @WDMITI — APPROPRIATE &, et y- 4V <br /> f�EAf!�t�rt —r'—"' <br />
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