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ARCHIVED REPORTS XR0000689
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 XR0000689
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Entry Properties
Last modified
2/15/2019 9:44:24 PM
Creation date
2/15/2019 4:07:51 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000689
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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0 <br /> Advanced CHAIN OF CU ODY RECORD <br /> GeoEnviron mental, Inc a�j 5- Dateos v Page -- of <br /> 4005 North Wilson Way-Simklon,cahlornia 95205 (209)467-1006 Fax(209)467 1110 <br /> Client Protect Man—f Tkinager <br /> Cue <br /> I� Tests Required <br /> ltze-- <br /> Phone Number , <br /> Ze I ? -/off <br /> F Samplers (Signature) Q\ �j invoice, <br /> Project Name .� AG#= <br /> Clien ❑ <br /> Sample Type <br /> Sample Location No of <br /> Number Description Date Time Water Solid \k Notes <br /> Comp Grah Air Contsr <br /> d � 5 0 �, <br /> 37521 <br /> l <br /> ttn � �1l/S � / /�; 3752 <br /> P-26 - / y��$ rl YV ld 3752 <br /> tt /0 / q'5;-7 \ Ik 3752 <br /> 11 / 5-/ /0.Z0 3752 <br /> << 1022- 3752 <br /> I I f <br /> P-29 <br /> 37527 <br /> - Ind � t,t�s <br /> u+s e ( rgn re} eceive y (Signature) �� patelflme <br /> ��i�—� 7A- 7 67 <br /> ROT11P shed by (Signature) nacerved by (Signature) Dale/Tlme <br /> nelinqurshed by (Signature) rleceived by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Dale/Time 0 ed I�boratory by � I DaleJFime <br /> } �, 'f��E,M1I_, l'1ll lrf 3 ffff w 'lJ ti I I <br /> VOLS <br /> Method of Shipment r` � CJr <br /> �rtni boralory Name /I <br /> i�rZr <br /> Special instructions r 5 p nj rr��}}�;rr srpp� 1 hereby authorize the perlorme ce of the above Indicated work <br /> i;1-ADL J fiv� � ��i1( ... 1r'Ji)ih('til1 <br /> 0a U CE: t Vtri i C,� ,z <br />
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