My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
ARCHIVED REPORTS XR0000683
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
C
>
CAPITOL
>
6421
>
2900 - Site Mitigation Program
>
PR0522496
>
ARCHIVED REPORTS XR0000683
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
2/15/2019 9:05:27 PM
Creation date
2/15/2019 3:59:29 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000683
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
Scanner
WNg
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
194
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
i i ! <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. gate Page — ot- <br /> 4005 North Wilson Way Stockton, Cal€forrlla-95205-(209)4674006-Fax(209)467-1118 <br /> Client Project Mana er <br /> i <br /> Tests Required <br /> P ne umber <br /> Samoa (Signature) Invoice <br />� Prosect Name <br /> ® L AGE 0 <br /> �rC a �GtCiLi fit3 �' Client ❑ <br /> Type Typ <br /> Sample Location SampleNo of 00Number Description Date Time Water Air Solid Costs '. 62482 <br /> ` <br /> Comp Grab <br /> 3 - 62483 <br /> f �r ) 62464 <br /> A to I3 ' -n to 62485 <br /> Im to 13J#S fiel <br /> e nquis a rg ura ecelva y gnature patelTlme i} <br /> ?II fir, l r l n <br /> Relinquished by (Signature) Received by (Signature) Oatefrime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysts (Signature) DaterTime <br /> Dispatched by (Signature) DalelTime Received for Laboratory 1�1 Date/Ti e <br /> Method of Shipment nboralory f[ { <br /> Special Instructions IE/{° 00' VOT <br /> RESERVATION I hereby oushorize the f rmance of the above indicated work <br /> noon r <br /> 1 <br /> HEADSR' rtr,� If <br /> ti��rIT CONT"S; �., 1 <br />
The URL can be used to link to this page
Your browser does not support the video tag.