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ARCHIVED REPORTS XR0000665
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 XR0000665
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Entry Properties
Last modified
2/15/2019 9:44:01 PM
Creation date
2/15/2019 3:16:34 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000665
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 <br /> � Advanced <br /> CHAIN F USTOD RECO D <br /> 4//GeoEnvironmental, Inc. Date Page <br /> 837 Shaw Road-Stockton, California-95215-(209)467-1006- Fax{209)467-1118 a <br /> Project Mara fl <br /> Client -�—T Tests Required <br /> Fi9ione umber <br /> 14 <br /> Sam r (S at e) Involc 11 <br /> /' P AGE �- <br /> Project Name / /�,� Client [] <br /> Sample Type <br /> Sample Location Solid No of Notes <br /> Number Description Date Time Water Air Conts <br /> Comp Grab " <br /> �y 1 _Z- -7 I-LIL <br /> FI <br /> I L <br /> i r � <br /> � l <br /> a <br /> e inq s +g slur eceiv y (Si na(ura + 0-<,- <br /> Rehn wished by (Signa ur ) a +v d by ( ignature) Da e/T+me <br /> Relinquished by (SignDatelTlma <br /> ature) Received by Mobile Laboratory for field analysis (Signature) <br /> `I <br /> °I <br /> Dispatched by (Signature) Date[T+me Received for Laboratory by DatelTime <br /> 1 <br /> Method of Shipment _ Lab o tory NameIteL <br /> 'I <br /> -f <br /> Spacial Instructions I her e4y honze the pefformance of the above indicated work j <br /> {I <br /> 'I <br /> ,ii' <br />
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