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ARCHIVED REPORTS XR0000262
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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B
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BANNER
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6437
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2900 - Site Mitigation Program
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PR0526345
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ARCHIVED REPORTS XR0000262
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Entry Properties
Last modified
2/5/2019 4:10:31 PM
Creation date
2/5/2019 3:51:49 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000262
RECORD_ID
PR0526345
PE
2957
FACILITY_ID
FA0017827
FACILITY_NAME
FLAG CITY SHELL
STREET_NUMBER
6437
Direction
W
STREET_NAME
BANNER
STREET_TYPE
ST
City
LODI
Zip
95242
APN
05532019
CURRENT_STATUS
01
SITE_LOCATION
6437 W BANNER ST
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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• 0 i <br /> A� MalySciences CHAIN OF CUSTODY <br /> P O Box 7503366,,Petaluma, <br /> aluma,CA 94975-8338 <br /> /t/V 110 Liberty Street,Petaluma CA 94952 <br /> S (707)769-3128 Lab Protect Number 1604 Z bi 4 <br /> Fax(707)76MO93 Client's Protect Name New West Petroleum <br /> a <br /> Clienfs Project Number NWP01 004 <br /> CLIENT 1AfF0RMAT1q*, <br /> Company Name ex Envirotech, Inc GeoTracker EDF Yes <br /> Address 11244 Pyrites Way,Gold River,CA 95670 Global 1D <br /> TURNAROU(i�p 7iiME(checkone)„ <br /> Contact Jennifer Wor-sley Same Day <br /> Phone# 915 851 0174 48 Hours 24 Hours <br /> Fax# 918 851 0177 5 Days x Ndrmal X Page of <br /> e-mail jennder@apexenvirotech cam <br /> GJ <br /> Date # Presv Lab <br /> Item Client Sample ID ALT ID Sampled Time Matnx Cont YIN Comments Sample# <br /> 1 EW-4 End 3 Y bouz�.lw- al <br /> i <br /> 2 <br /> 3 <br /> 4 <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 8 <br /> 18 <br /> sIGNAT R <br /> UES' i <br /> Irnq i ed t3y Sampled By C, �SS <br /> Re ed S <br /> - / <br /> q--a5'4& -SL/5" <br /> Si ature Date Time Signature Date Time <br />
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