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ARCHIVED REPORTS XR0012758
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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C
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CAPITOL
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6421
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2900 - Site Mitigation Program
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PR0522496
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ARCHIVED REPORTS XR0012758
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Entry Properties
Last modified
2/15/2019 4:45:15 PM
Creation date
2/15/2019 2:49:39 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012758
RECORD_ID
PR0522496
PE
2957
FACILITY_ID
FA0015317
FACILITY_NAME
FLAG CITY CHEVRON
STREET_NUMBER
6421
STREET_NAME
CAPITOL
STREET_TYPE
AVE
City
LODI
Zip
95245
APN
05532024
CURRENT_STATUS
02
SITE_LOCATION
6421 CAPITOL AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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ar r :Fj• '� a <br /> a 1 <br /> i <br /> i <br /> I 17L <br /> 1 <br /> i <br /> Chain-of-Custody Record <br /> t� _ <br /> Cfiov:on Facility No. ••_ '!� - �Chevran Conlacl(Name) <br /> Facility Address y .l - ° A (Phone) <br /> [Chevron U.S.A.Inc. <br /> Consultant Project Number I J 1' ] _ Laboratory Name <br /> P.0.8ox50ea SIERRA ENVIRONMENTAL SERVICES <br /> Consultant Name <br /> San Ramon,CA 94583 Laboralory Roloase Number I <br /> FAX(415)842-9591 Address P.O. Box 2546, Martinez, CA 94553 €y <br /> Samples Collocted by(flame) -� — <br /> Project Contact(Name) 01"' l <br /> (Phone)_(415) 370-1280 Collection Data <br /> (FAX Number) (415) 370-7959 Si nature _ <br /> 9 <br /> — ANALYSIS TO BE PERFORMED tP <br /> b <br /> h U b <br /> �, <br /> o ¢ <br /> � l <br /> 4' <br /> I t <br /> j <br /> q, <br /> - _-. <br /> mm <br /> 11 uiaB Ippatuse) Orpanliatlon Da [me Aecolved By(Sii __--__ Orgarrlxatlon-_.-.__oalafrlma - ruin Mound tin,.(C—W anal _ <br /> q j <br /> By <br /> II <br /> R• y hours <br /> ei u B (Signa aJ organitallon 1 kna Rc,:*Nwd By("analuraJ prpanitalbn bnlafrlme 40 hours + r <br /> Y. <br /> RatthqulaMd By 5 alure _ .-pti.._-- palartlma illy �Lab�ory��1pn �1 ._.... Dalelr4m• �j An t odays ed y fry <br /> ( � 1 t]f nitalbn � � •j � <br /> f I <br /> yip h y f <br />
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