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ARCHIVED REPORTS XR0004097
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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K
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KETTLEMAN
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2449
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3500 - Local Oversight Program
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PR0543823
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ARCHIVED REPORTS XR0004097
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Entry Properties
Last modified
10/22/2018 1:06:47 PM
Creation date
10/22/2018 10:52:59 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS XR0004097
FileName_PostFix
XR0004097
RECORD_ID
PR0543823
PE
3528
FACILITY_ID
FA0003760
FACILITY_NAME
SUNWEST LIQUORS
STREET_NUMBER
2449
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95242
APN
02741005
CURRENT_STATUS
02
SITE_LOCATION
2449 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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■_ � s <br /> . Lab Report# <br /> GeoAnalyticai Laboratories, Inc. Regulatory ©Yes DNS cc: Dyes DNo <br /> 1405 Kansas Avenue Phone: (209)572-0900 Regulator <br /> • <br /> Modesto, CA 95351 Fax: (209)572-0916 • <br /> Phone: (Zaq 3(V a 4 3 ! _ <br /> Client: F rVH I t- &1V 41^l V-f� IV it..- CHAIN OF CUSTODY Fax: (may) 76, 7 !1 tO 3 <br /> Address: Il-7'13 ROVAPY 4-r�k—" D EDF D EDT Original To: <br /> City LODI GA zip Y 7, 410 _ D FIELD LOGS C.0 To: <br /> Lab Use Only <br /> Project ID <br /> (Print Name) <br /> Sampled By k U <br /> (Signature) Container o Q a �` <br /> Sample type Sample ID z <br /> Date Time Type Size Rem2rflkv <br /> Grab Comp Matri <br /> VOA <br /> G�I qa,y L,t- 0 - <br /> i <br /> i <br /> `S N <br /> Remarks s� oro U '°v�� <br /> ` Tmae Received by( re) Une <br /> `,F:2� <br /> Relinquished by(Signature} �fj �' ` Lq <br /> Relinquished by(Signature) <br /> Date Time R iv y(Si tore) a <br /> Preservative: Matrix <br /> O4 IDNaOHO Na2S203 0-HNO3 O-H S 04(VMer Drinking Water®Waste Water 4= Hazardous Waste(Water)GSoiUSolid <br /> Pump Truck Time Mileage <br /> ` Bailers 55 Gallon Drums D <br /> Approved By: <br /> T uu L,1 Su lard ❑Silver Rush QGOIdRush Plalinum Rush 00tbtr <br />
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