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ARCHIVED REPORTS XR0000647
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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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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- -� • <br /> 2 <br /> Advanced CHAIN F CUSTODY PECORD <br /> GeoEnvironmental, Inc. q(� J�f Date Page __fof <br /> 837 Shaw Road - Stockton, Callfornia 95215- (209)467 1006 Fax (209) 467-1119 <br /> Client f f Pro,� t.lWanager <br /> Tests Roared <br /> on umber <br /> nmi s (SI nature) r Invoice <br /> Project Name �� , �{ AGE <br /> Z Client Q <br /> Sample Location Sample Type f _s <br /> Number Description Date Time Water Air Solid No <br /> Notes <br /> Coinp (arab <br /> ,rte <br /> e <br /> i <br /> a u e atur eceive y grtature <br /> wril <br /> Relinquishe by (Sig azure) Received by (Signature) Do <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Cate/Time <br /> Dispatched by (Signature) Date/time Roca -d aboratory by <br /> E <br /> Method of Shipment pLaborator N <br /> �tEC D SEALED&INTACT VIA (f me <br /> 1-41wp 674--_ <br /> Special Instructions ICElt°_____ f hereby a orize th rforma ce of the above indicated work <br /> GOOF)CONDITION--_-:f� APPROPRIATH <br /> bECHLORINACEO IN LAS PRESERVED IN_LAB_ <br /> sBlk l n!A 0&0 1 NISTALS 077Ifil�_ <br />
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