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ARCHIVED REPORTS XR0000681
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 XR0000681
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Entry Properties
Last modified
2/15/2019 6:59:54 PM
Creation date
2/15/2019 3:57:14 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000681
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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Advanced CHAINjOf CUSTODY RECORD <br /> GeciEnvirnnmental, Inc. 'r Z c Date Page 4t <br /> ���� <br /> 837 Shaw Goad-Stockton, California-09215- (209)467-1008- Fox (209) 467-1118' <br /> Client Project Meger <br /> Tests Required <br /> P ne Number <br /> rr <br /> jer$, (Signature) Invoice; <br /> Project NAG ame <br /> E <br /> Client ❑ <br /> Sample locati n Sar a ypa <br /> Date Time No of <br /> Number Description Water Air Solid Conte Notes <br /> Comp Grab <br /> -7-7-2-36 - <br /> 17-237 <br /> ---77238 <br /> _____7_7_239_ <br /> SA-4 9-o4-ol Iq 50 A_ ;}_ - 7729_0 <br /> —7-7 2 4 A <br /> - 4 w01 , <br /> 77242 <br /> ReKnqufs:Ze7y�(�Slgnaturs)U <br /> ee va l <br /> Y Ona ure r <br /> Is/1 ems <br /> WeReceived by (signature) L <br /> OaterTime <br /> e inqu a s by (Signature) Received by Mobile Laboratory for field analysis (signature) Dalefrime <br /> Ofepstohad by (signature) ate meaq a or q orate �. �I ate/Ttene <br /> Method of Shipment Labdiator me <br /> special Instructions F 1 1khereb auth flim the pe formance of the above Indicated work <br /> 1IDDSPACEA- <br />
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