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ARCHIVED REPORTS XR0000687
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 XR0000687
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Entry Properties
Last modified
2/15/2019 7:31:54 PM
Creation date
2/15/2019 4:05:34 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000687
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, Date- t,' Page _ of <br /> 837 Shaw Road-Stockton, California-95215 - (209) 467-1006 Fax (209)467 ill8 <br /> Client l�C;. �.� <br /> Project Manager Tests Required <br /> Phone f41omber <br /> Samplers (Signature) i invoice <br /> Project Name --� � �i �r, ,p�U AGE j�a <br /> Sample Location Sample Type <br /> Number Description No of <br /> Data Time Water Solid ���{)� <br /> p comp arab Air Conti86104 <br /> w <br /> 2-0 <br /> 86105 <br /> -. 86107 <br /> 86108 <br /> L r F 83109 <br /> e(nqu s e rg lure ace ve y gnature <br /> �✓ � y� ,I ,Uarar l Itoio <br /> Gv f(.,)LI <br /> Relrnq a ed by (S nal Received by (Signature) 1 <br /> � II <br /> Detafrime <br /> Relinquished by (Signature) Received by Mobile Laboratory ic, ueid anatysin (Signature) Datellime <br /> Dispatched by (Signature) Date/Timu �` cell red f0i aboraiary by Date(rin(e <br /> Method of Shipment f Laboratory llama <br /> Special instructtona V it1 Iti liE�1 � { ti I hereby euth raze the performance of the above Indicated want <br /> PEI SCRVAMN <br /> �A <br />
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