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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 CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Die ease of . I_ <br /> 4005 North Wilson Way-Stockton,Califomla-95205-(209)467-1006-Fax(209)467-1118 M /I f Gt/j 0 Li <br /> Client Project Manager <br /> Testst <br /> Required <br /> P one Number <br /> 160 <br /> S ers ignature} Invoice <br /> Project Name AGE <br /> Client ❑ <br /> Sample Location Sample Type No <br /> Date Time Water Air Salm Cantsf Notes <br /> Number Description Comp arab <br /> -12 M3o(0d <br /> F <br /> e inq is had y at ece ve ynature atomme <br /> 4 F <br /> '7117 <br /> Relinquished by ( ignature) Received by (Signet re} G <br /> Date1'rlme <br /> Relinquished by (Signature) Recelved by Mobile Laboratory for field analysis (Signature) Data/Time ' <br /> i <br /> Dispatched by (Signature) Date/Time Receive or La story by Dateffime r <br /> Method of Shipment Lab ra ry Neme 3 <br /> ` <br /> Special Instructions i herebyorixe thn <br /> parlor ante oft a above indicated work <br /> t <br /> a <br /> rn <br />
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