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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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WNg
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EHD - Public
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Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc Date to/xi Ic qPage <br /> 837 Shaw Road- Stockton, California-95215- (209)467-1006-Fax (M)467-iii a <br /> Client �— Prolect manager <br /> t V', Tests RequiredPhone Number <br /> Samplers (Signature) Invoice <br /> Project NamAGEe�1 <br /> Cheng <br /> Sample Location sample Type <br /> Number Description Date Time (Nater Alr Solid Contst <br /> Comp Grab / Notes <br /> I L(e �C <br /> vis t MjV <br /> �V(TeW�k� <br /> r e14 <br /> inqu s a ign e <br /> eoe ve y gnaiure <br /> ehnquish.d by (Signature) Received by (Signature) <br /> Data/.Me <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) <br /> Date(Time <br /> Dispatched by (Signature) DatelTrrne R Laboratory b <br /> ate�Time <br /> Method of Shipment L o tory Name <br /> 'I.L Cats <br /> fiQeciel Instructions I harepy uthorizeIha performance he above indicated work <br />
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