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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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0 0 <br /> Advanced CHAIN OF CUSTODY RECORD <br /> - �� � Page � of <br /> GeoEnvironmental, Inc Date <br /> 837 Shaw Road-Stockton,California 35215- (209)487-1008 -FaA(209)467-1118 <br /> Project Man? r Tests Required <br /> � <br /> Client I <br /> Z4 <br /> VuMber � <br /> (, ) �67 jok { <br /> ler s- (Si nature) n Invoice <br /> Vo- <br /> Project Name Client ❑ <br /> Sample Local n Sample Type c of <br /> Number Description Date Time Water Air Solid Cents Notes <br /> Comp drab <br /> 7 <br /> ll -1 <br /> —:LLEIL <br /> e inqu y ignatut ace ve y gnature Oat fFime <br /> 4: r 1730 <br /> W <br /> elin shed by (signature Received by (Signature) D terTime <br /> Re Inqulshe- by ( ignatura) Recelved by Mobile Laboratory for fiaid analysis (Signature) � Datetrime <br /> Dispatched by (Signature) Daleffime R Aboratoty by >Ja !Time <br /> 011 <br /> Method of Shipment Labo o�y a <br /> C, , 6J A <br /> lSpacial in'shuctsons I hereby aur ixa the arfor ance of the above indicated work <br />
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