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ARCHIVED REPORTS_XR0008146
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_XR0008146
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Last modified
5/5/2020 3:22:34 PM
Creation date
5/5/2020 2:35:19 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008146
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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EHD - Public
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� � � � v � � � � l• � t• � t• s i_ tflif� �■ <br /> CHAIN OF CUSTOPRECORD <br /> Advanced _ ,� Date 7-112-t2 03 Page --L Ofr <br /> GeoEnvironmental, Inc. �, <br /> 837 Shaw Road- Stockton, California-95215- (209)467-1006- Fax (209)467-1118 <br /> Client ,� V �— PAAtn ger eats Required <br /> Pne Number <br /> OM0 <br /> SM(Si <br /> Irriwe <br /> Project Name �� <br /> ' [LCL. � <br /> Client ❑ <br /> Sample Location Sample Type Solid No of NotesNumber Description Date Time Water Air Conts <br /> Comp (arab <br /> -�l�A 1 1 <br /> 20d <br /> Relinquished y tgna r ecewe y ignature D alit no <br /> Relinquished by (Signature) Received by (Signature) Date/Ttme <br /> Relinquished by (Signature) Received by Mobile Laboratory for held analysts (Signature) DatelTame <br /> Dispatched by (Signature) Date/Time Received r Lab tato _ ate/Time <br /> Method of Shipment �'� abor Nam -� <br /> LLIA� � <br /> T t <br /> Special Instructions t hereby authorize performance of the above indicated work <br /> C <br />
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