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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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aaai�a �� e� � stir iso t� its eta dpi■■ � iii• !i � t� � � � <br /> ( Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc, Date Page J— of� <br /> 837 Shaw Road-Stockton, California-95215-(209)467-1006- Fax (209) 467-1118 <br /> Client Project Maq#ger <br /> Tests Required <br /> Pne Number 10 <br /> s <br /> ers (Signature) Invoice. <br /> Project Name i AGE Q` <br /> Client ❑ <br /> Sample i_vcati n 5amp a Type f <br /> No O <br /> Number Description <br /> Date Time Water A)► Solid Contsf Notes <br /> comp (arab <br /> _77.736 <br /> , - - 77737 <br /> r99-,en) 11155 <br /> I <br /> 4 <br /> �•. �d ,� __-___77.239_ <br /> i <br /> -oi 50 �,- - - 77240 <br /> P/;;ir -� &9..o( ~o <br /> � <br /> Fwoli—;z , <br /> i 77242 <br /> Fie"se g ature ec ve y gnatureWeide oRe (Signature)Q(Signatur*)Q Received by (Signature) &w <br /> p atarrim e <br /> ellnqu s a y (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> 9 /\ <br /> Dispatched by (Signature) Oale/Tlme R e for $ orator slafTime <br /> Method of Shipment La sato me <br /> Special Instructions OV, ,� _ f _ rhe►eb auth rlxe the pe lormance of the above Indicated work <br /> r <br /> (^ v� rwl A a <br /> iL <br /> `,f-,'0 dPACE;`K�.ik� Ab �. <br />
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