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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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�� i i • <br /> ( Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmentai, InC. Qq O O <br /> �. Date Page ---L of <br /> 837 Shaw Road-Stockton, California-95215- (209)467-1006 Fax (209) 467-1118 <br /> Client Project Mana � i <br /> Tests Required <br /> Phone Number <br /> ters <br /> ature) Invoice <br /> Project Name AGE <br /> (� (f4/ Client <br /> Sample Locat n Sample Type .00 <br /> --�—�--- <br /> Number Description Date Time Water Solid No of <br /> Cornp Qreb <br /> Air Conts Notes <br /> +- W <br /> e inquws y nature <br /> one ve <br /> y igna ra <br /> 0a (rime <br /> Relinquished by Signature) Received by (Signature) <br /> at /Time <br /> Relinquished by (Signature) Recelved by Mobile Laboratory for field analysla (Signature) <br /> C3ats/Tlme <br /> Dispatched by (Signature) Daten'itne oecow o oratory y t /rim <br /> Method of Shipment <br /> Laborato a <br /> e t <br /> SpeoialllraLtucitons „ _,__ J <br /> h Wt° `� TW"r y 3tI415or1Ye the rformance of She above indicated work <br /> GOODCONi)tTION �!DRRdpRfATH <br /> ` <br /> DE(-11L0ldltdAfLD IN I AB-PRESERVED IN LA <br /> VOA$ 6&0 1!!ETALS I 011MI t <br /> I'RtSFRVATIdZ <br /> i <br />
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