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ARCHIVED REPORTS XR0000647
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 XR0000647
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Entry Properties
Last modified
2/15/2019 7:51:52 PM
Creation date
2/15/2019 3:08:16 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000647
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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e <br /> Advanced CHAIN OF CUSTODY RECORD <br /> !3� , JJ <br /> .;� GeoEnviron�nental, 1I1C Date Page � of t� <br /> 837 Shaw Road- Stockton, California 95215- 209 4 <br /> ( )467-1006 1006 Fax (209)467-1118 <br /> Client z rr `� t project Manager Tests Required <br /> Pone Number <br /> Samplers fsi �r Invoice <br /> Project Name y ' —tLA AGE <br /> /, Client ❑ <br /> Sample Location Sample Type <br /> Date Time Water_ Solid No of <br /> Number Description Air conts f `" / Notes <br /> Comp Grab <br /> I <br /> ilk" n(D kAuj L(D 1-737 <br /> ri <br /> h d hy eat Receiveda natu:s 10 X <br /> / e171m <br /> 7 ��ti P D S Ohf F ADSL j 1 G <br /> ----,.-.�.. ./tt'1'1tOPAY4f5 ( � L+j <br /> x3f'A15 SrAE'E AllS1.T�T rnwo�. L <br /> ) - err tii33mt,�` <br /> Relinquished by {Signature} Received y'f{ftdi W% Lr INY AB- crP1tESER1'LD 1N LA ate(Time <br /> PRESERVArrO VOA1).917, MET"IS}r OT11ER <br /> Raknqumhed by (Signature) Received by Mobtia Laborut ry or i Signotute DatelTime <br /> oispatchad by (Signature) Rate/Time RsceEved for Laboratory by ❑r;t s! �n3a <br /> Method of Shipment Laboratory Flame s <br /> Special knetrucpona r� � - � i I her �y�aujtliarize the P 61411rman of the above indicated work <br />
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