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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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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_XR0008150
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Entry Properties
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
Scanner
LSauers
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EHD - Public
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ifii� i i� fJ� i■!� iiiifi� � � f� � >il� � � i ii>� i, � : � <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvir_onmental, Inc. `") r^a - aate� l Page of <br /> I <br /> sIC <br /> 837 Shaw Road - Stockton, California- 95215- (209) 487-1008- Fax(209) 487-1118 <br /> Client '`�eiy � I f :1 Project Manager <br /> L A pp l 3; <br /> a- Tests Required <br /> A7L Phone Number <br /> voC <br /> Samplers (Signature) Invoice <br /> Project Name 'P N(,�A . � AGE <br /> 1 ti� Chent ❑ <br /> Sample Location Sample Type <br /> Number Description ©ate Time Water Solid No of Notes <br /> comp Grab Air Conts <br /> e muss to y ( rgnature} ece ve y igna-ure <br /> Qame <br /> ehngoit� ( rgnature ��" Received by (Signature) ! 4T �p telTlme <br /> r� Q&d 14r�"t'AL.S fl7tirA <br /> ICED' MESERVAI70. �J <br /> Relrngdi H 1N>I�II re APPROPRi.`t7`, Received by Mobile Laboratory for field analysis (Signature} <br /> HEAD SPA[1E ABSENT CONTAME S DatelTrme <br /> Dispatched by (Signature) Date/Time Received for Laboratory-by - <br /> Method <br /> y -Method of Shipment � aboratpry � 7 <br /> mc <br /> 5pectai 1nslrtictirs ! r �� w` I here-Wauthorize a performance of the above indicated work <br />
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