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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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P
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PACIFIC
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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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w � � � � � i r_ s � � � +■�� war � <br /> Mccamp ell Analytical Inc. <br /> • s <br /> P y CHAIN-OF-CUSTODY RECORD Page 1 of <br /> 110 Second Avenue South,#D7 <br /> Pacheco,CA 94553-5560 <br /> (925)798-1620 WorkOrder 0204360 <br /> i <br /> Client <br /> Advanced GeoEnvironmental TEL (209)467-1006 <br /> 637 Shaw Road FAX (209)467-1118 <br /> Stockton,CA 95215 ProjectNo Pacific Mini Mart <br /> PO 23-Apr-02 <br /> _ Requested Tests <br /> Sample ID ChentSamplD Matrix Collection Date Bottle .-E150_1 E200=7_ 5200_9 SW8015C 802113/8015 r ` <br /> 0204360-001 INFLUENT Water 4122102 B A <br /> 0204360-002 EFFLUENT Water 4122102 C C C B A <br /> Comments <br /> - Date/Tame --- —1 Date/Time <br /> Relinquished by: Received by. <br /> Relinquished by Received by: <br /> Relinquished by: Received by: <br /> NOTE 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-Orbe T-Tedlar B-Brass P-Plastic OT-Other <br />
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