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ARCHIVED REPORTS_XR0008119
Environmental Health - Public
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EHD Program Facility Records by Street Name
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4511
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3500 - Local Oversight Program
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PR0545641
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ARCHIVED REPORTS_XR0008119
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Last modified
5/5/2020 3:32:46 PM
Creation date
5/5/2020 2:21:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008119
RECORD_ID
PR0545641
PE
3528
FACILITY_ID
FA0002480
FACILITY_NAME
SHOP N GO 3
STREET_NUMBER
4511
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
11023011
CURRENT_STATUS
02
SITE_LOCATION
4511 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 <br /> McCamp ell Analytical Inc. CHAIN-OF-CUSTODY RECORD Page 1 of 1 _ <br /> 110 Second Avenue South,#D7 <br /> Pacheco,CA 94553-5560 <br /> (925)798-1620 WorkOrder. 0205187 <br /> Client <br /> Advanced GeoEnvironmental TEL (209)467-1006 <br /> 837 Shaw Road FAX (209)467-1118 <br /> Stockton, CA 95215 ProtectNo Pacific Mini Mart <br /> PO 14-May-02 <br /> Requested Tests <br /> Sample ID CllentSamplD Matrix Collection Date Bottle E200 7 SM4500H+B SW8015C 8021B/8015 SW826001�_ SWS270D ____ <br /> 0205187-001 Influent Water 5113102 1 45 00 PM _ A <br /> 0205187-002 Mid Treat Water 5113102 1 35 00 PM A <br /> 0205387-003 Effluent Water 5/13102 1 30 00 PM C E C A B D <br /> Comments. <br /> Date/Time -- Date1T>me <br /> Relinquished by. Received by <br /> Relinquished by: Received by- <br /> Relinquished by Received by <br /> DOTE Samples are discarded 60 days after results are reported unless other arrangements are made Hazardous samples will be returned to client or disposed of at client expense <br /> Bottle Type L-Liter V-Voa S-Soil Jar O-Orbo T-Tedlar B-Brass P-Plastic OT-Other <br />
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