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ARCHIVED REPORTS_XR0008150
Environmental Health - Public
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EHD Program Facility Records by Street Name
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3500 - Local Oversight Program
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PR0545641
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ARCHIVED REPORTS_XR0008150
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Last modified
5/5/2020 3:40:53 PM
Creation date
5/5/2020 2:37:48 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008150
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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� � � � �� � � � l� � 1• � � � !� tttttttttt� �� ttttttttttts <br /> McCamp ell Analytical Inc. CHAIN-OF-CUSTODY RECORD Page ` of ` <br /> 110 Second Avenue South,#D7 <br /> F Yachcco,CA 94553-5560 <br /> (925)798 1620 WorkOrder 0301169 <br /> Client <br /> Advanced GeoEnvlronmental, Inc TEL (209)467-1006 <br /> 837 Shaw Road FAX (209)467-1118 <br /> Stockton, CA 95215 ProlectNo Pacific Mini Mart-0112003 Date Received 1115103 <br /> PO Date Printed 1117103 <br /> ---- - - - - Requested Tests - -- W <br /> Sample ID ClientSamplD Matrix Collection Date Hold SM4500H+B i SW8015C 1, 8021B18015 1 _SW82608 <br /> L301169-001 Influent Water 1 1114/03 2 00 00 PM j A A B <br /> 0301169^002 � _ EffluentM- - Water I 1/14/03T45 45 00 PM i 1 G_ <br /> Prepared by Elisa Venegas <br /> Comments <br /> NOTE Samples are discarded 60 days atter results are reported unless other arrangements are made Hazardous samples will be returned to client or disposed of at client expense <br />
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