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ARCHIVED REPORTS XR0000669
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 XR0000669
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Entry Properties
Last modified
2/15/2019 6:24:49 PM
Creation date
2/15/2019 3:19:54 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000669
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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� �� a� alp � �]] � f� � � � � � I♦ li li <br /> Advanced CHAIN OF CUSTODY RECORD - <br /> GeoEnvironmental, Inc. bate rz Page of <br /> 837 Shaw Road - Stockton, California -85215 - (209) 467-1006- Fax (209) 467-1118 <br /> Client � � � Pros ` anag <br /> i 'QTests Required <br /> Ppene Nymber <br /> 3AllLo 6 <br /> a ere (S nature) r Invoice <br /> Project Name ��� AGE <br /> Client <br /> Sample Loca n Sample Type <br /> Number Description Date Time Water Solid No of �C " Notes <br /> Comp Grab Air Conts <br /> AIAJ14 112_e)6__e1z <br /> X65 <br /> _Uk) � <br /> M a) <br /> Z-�4, - r z <br /> J4 <br /> XZ l I <br /> e inquis y ignature ece a gn urs <br /> D le/Tims�� <br /> Ralinqui d by S g re) iieceiv nat re � Date/Time <br /> Relinquishe by ig ature) Received by Mobile Laboratory for field analysis (Signature) <br /> Date(Time <br /> Dispatched by (Signature) DatelTime Received for Laboratory by Date/Time <br /> Method of Shipment l Laborato y m <br /> ae <br /> / �10 t1 <br /> Special Instructions t hereby a ize th performance of the above indicated work <br />
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