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ARCHIVED REPORTS XR0000661
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 XR0000661
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Entry Properties
Last modified
2/15/2019 6:54:56 PM
Creation date
2/15/2019 3:13:39 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000661
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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� � � � � � � � � � � � � � f• ! fi ifs � <br /> Advanced <br /> CHAIN OF UST D <br /> ��[���'� <br /> C O PRECORD <br /> r-- GeoEnvironmental, Inc ( rj 0�^ nate Page of <br /> 4005 North Wilson Way Stockton,California-95205 (20 467-1006-Fax(209)467-1118 <br /> Client Project Manager <br /> �t l� � Tests Required <br /> P ne Number <br /> 7 �' l ? 17 <br /> /1 a pl rs (Sinature Invoice <br /> Project Namer1alf - t /U��, �f ,�/ f �� AGE, <br /> / l�L I Client <br /> 7 <br /> Sample Location pate Time Sample Type Solid No of <br /> Number Description Water <br /> Comp Grab Air Conts Notes <br /> 1{ - i <br /> 53, el, 314 <br /> �d C , - ; <br /> �` r� X t <br /> 53315 <br /> ' � t , <br /> e,nqu s e ( r azure) ecetve y -Mg nature) <br /> fli U DatelTtme <br /> U C` <br /> Ref,nqutshed by (Signature) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> _ t 1 <br /> Dispatched by (Signature) Date/Time Received for Laboratgry by ate/Ttme <br /> 1,VA .� ��� 0u �E"s <br /> Method of Ship m Labor M'e <br /> t'-4zyr�zz <br /> Special Instructions V0AS ±0VN','LTA15J0T11rLR f hereby au o ze the p rformance of the above indicated work <br /> l ' <br />
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