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ARCHIVED REPORTS XR0000667
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 XR0000667
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Entry Properties
Last modified
2/15/2019 10:16:01 PM
Creation date
2/15/2019 3:18:08 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000667
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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Advanced CHAIN OF CUSTODY RECORD <br /> �~ D�V �O Date zZ d page —� of� <br /> GeoEnvironmental, Inc. <br /> 837 Shaw Roars- Stockton, California- 95215- (209)467-1006 - Fax (209)467-1118 <br /> Client Project Manager <br /> 71-1 L Tests Required <br /> P one umber <br /> 0 � <br /> S ers (SI nature) Invoice <br /> Project Name AGE 0 <br /> 0 r(S �� Client ❑ <br />' Sample Location Sample Type <br /> pate Time Water °� Notes <br /> Number Description Water 'air Solid Cants <br /> Camp Grab <br /> f3 FJi t� <br /> 1H 0 T/ <br /> t ALB <br /> +�t7GbGC3 CT.'i"'Ll,x � CY1'RL . <br /> TMF.— <br /> OAUSEA <br /> 'f <br /> s IStls t o 1�r1Y a YY IV <br /> e inquis y i lure Receivedy (Signaturey— <br /> telTime <br /> Rellnqulshed by ( gnature Y (signature) DaReceived b Si a 7G=� <br /> telTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Daleffime <br /> Dispatched by (Signature) Dale/Tlme Re v f Laboratory by alelTlme <br /> OP 04o� O� <br /> Method of Shipment Laboratory e <br /> Special i strucliins heists) autho a the per mance the above Indicated work <br /> oil��Y � 1- �e �� ct� <br />
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