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ARCHIVED REPORTS XR0000643
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 XR0000643
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Entry Properties
Last modified
2/15/2019 6:19:45 PM
Creation date
2/15/2019 3:02:51 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000643
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
Scanner
WNg
Tags
EHD - Public
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Advanced <br /> CHAIN OF CUSTOJkECORD <br /> Geonvironmental, Inc. Date page <br /> 837 Shaw Road Stockton, California-95215-(209)467-1006- Fax (209)467-1118 <br /> Client j Project Manager <br /> - � ,�� Tests Required <br /> Ph no Number If <br /> Samplers (Signature) Invoice <br /> Project Name / AGE <br /> Client <br /> Sample Type <br /> Sample Location No of <br /> Date rime Water Solid Notes ,I <br /> Number Description comp arab Air Coots <br /> .r <br /> UU <br /> �F <br /> J <br /> I <br /> -LL <br /> 'i <br /> Bal <br /> rnq +a e y nature) ace ve y Igoe ura Dote/Time t 0 <br /> Re qurshed by (SI re) Received by (Signature) DateRrme <br /> m �h <br /> 7 <br /> STf <br /> `�� Datefrrme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Ij <br /> < <II <br /> Dispatched by (Signature) DatelTNna �*d oratory by D e/T a <br /> 6zz Lam, <br /> Method of Shipment Labor Name <br /> hi— <br /> Special Inattucllons [` 1 <br /> 1 her y authoriz the pe o anae of the above indicaled work <br /> n .r <br /> I� <br /> i f <br /> u i <br />
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