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ARCHIVED REPORTS XR0000670
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 XR0000670
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Entry Properties
Last modified
2/15/2019 6:43:40 PM
Creation date
2/15/2019 3:21:43 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000670
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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•EMISSION <br /> f <br /> Advanced � 40 0 -Up CHAIN PF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date Page of� <br /> 837 Shaw Road- Stockton, California-95215-(209)467-1006 - Fax (209)467-1118 <br /> Client Poe ane <br /> Tests Required <br /> PN N ber <br /> ,PoCod <br /> Samplers (Signature) Invoice <br /> Project Name7/CA0AGE <br /> Client ❑ <br /> Sample ocation Sample Type <br /> Date Time Water Solid No of Notes <br /> Number Description camp Grab Air Conts <br /> � l <br /> d,742 I Na <br /> SLC( I2-%ei <br /> Lf°c' <br /> e in a gnat a 4, ,`a�d <br /> e y ignaturo <br /> D e/Time <br /> Relmq is ed by (Signal ey {Signature) atefTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Datefrime <br /> Dispatched by (Signature) DatefTEme Received for Laboratory by DatefTime <br /> Method of Shipment LaboratoPam* <br /> ti -4 Re-4" /PA-tZ <br /> Special Instructions I hereby performanc of the above Indicated work <br />
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