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ARCHIVED REPORTS_XR0008162
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_XR0008162
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Entry Properties
Last modified
5/5/2020 3:10:48 PM
Creation date
5/5/2020 2:39:44 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008162
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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` � <br /> I Advanced CHAIN OF C ST Y REQ z-t <br /> "L. <br /> GeoEnvitonmental, Inc. Date Page of • �,t! <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 <br /> ClientAT Project Manager Tests Required <br /> y'�. \,.ii <br /> Phone Number 6 7— `�� <br /> 6 <br /> Samplers (Signature) Invoice <br /> i AGE <br /> Project Name ( Is Client ❑ <br /> � r <br /> Sample Location Solid Sample Type No of Notes <br /> Number Description Date Time Water Air Conts N <br /> Comp (arab <br /> r <br /> co 63,(s 90592 <br /> e i uis a P n raJ e y igna e f Date/Time <br /> � _ L`r std <br /> 'Relinquished by (Signature) --s Re ived by (Sra ire) DalelTime <br /> f5 <br /> Relinquished by (Signalurpk Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by I(Srgrlfiture - .� Date/Time Received for Laboratory by Date/Time <br /> Method of Shipment ��i t1G Laboratory Name <br /> C <br /> Special Instructions V0 O&G MCfAIS 010 I hereby authorize the perform ce of the above indicated work <br /> GOOD CONDITION _ APPROPRIATE <br /> HW SPACESUIT AL CONTANK—M. <br />
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