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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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• <br /> N �OD <br /> ( Advanced CHAT OF CUY RECOon <br /> co GeciEnvironmental, 1110 Dateo <br /> c1 Page of <br /> 4005 North Wilson Way-Stockton California 95205 (209)467 1006-Fax(209)467-11 1D <br /> Client '( C Project Mana ec—r _ <br /> �., Tests Required <br /> Phone Number <br /> r Samplers (Signature) Invoice <br /> Project Nance 4/- All / pry a AG� <br /> Cite ❑ <br /> Sample Location Sample Ty <br /> No of <br /> Number Description <br /> Date Time Comp <br /> Wat crab Alr Solid Conks r ��O Notes <br /> P <br /> 375 <br /> � <br /> z <br /> 5Z r 1 �cf ~ 3 7 5 <br /> `` �0 � /�1Q / r• _ �i 3 75 <br /> z - , <br /> la X 4 3753�oh� , <br /> 3753 <br /> 3z 3754 <br /> Z3 � r / 1- o 3754 <br /> rquis y i attire) eceive y ignatura �� Daterrime <br /> Dl?ylinlin wished by (Signature) received by (Signature) Date/Time <br /> flelinrlumhed by (Signalure) received by Mobile Laboratory for held analysis (Signature) Dale/Time <br /> Dispatched by (Signaturece ed for Lab_orat► )+ Ti or b cel DalerTime <br /> FTO V <br /> Method of shipment r11C t '' -- La oralory Name <br /> 11i1 un"TI �,i ,ti C !1 <br /> Speciallnstruclionsrr+ ° r - <br /> �'����tr�r ��iS Ji C�,�1, i1_i � i hereby authorize the parlor once ar ti,e above indicated work <br />
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