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ARCHIVED REPORTS XR0000674
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 XR0000674
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Entry Properties
Last modified
2/15/2019 7:32:34 PM
Creation date
2/15/2019 3:34:15 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000674
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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o405d9 5 <br /> Advanced CHAIN 9F CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date Page -�___ of__ ___ <br /> 837 Shaw Road - Stockton,California-95215- (208)467-1006 -Fax (209) 467 1118 <br /> Client Project Manager <br /> Tests Required <br /> Pone N miser <br /> pie (Signature) invoice <br /> Project Name AGE <br /> Client <br /> Sample Location Sample Type r <br /> Number Description Date Time Water Air Saud C ntsr 1/ Notes <br /> Comp drab �' ` <br /> of <br /> r , <br /> 00 co <br /> SPA E A 5 PR[ATt; <br /> ECH'OPUTI114�AK <br /> CONTAtN$R <br /> PRPSERVSD <br /> ES RVo 1+Er qtl <br /> e nq i s ySi at re sce ve y gnalura <br /> p eff e <br /> Rel nqu she by (Signature Received by (Signature) VW'111J--6&6 <br /> D e/ irrte <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) <br /> f}alelTlme <br /> Dispatched by (Signature) Date�7ime Ree r oratory by <br /> —��aZa/T3me <br /> Method of Shipment 0Laborala N <br /> Spactat tnattuationa � <br /> I hereby au a Ize th rforrna ca of the above Indicated work <br /> L <br />
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