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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 CUSTODY RECORD <br /> ��, GcoEt�vtt cmmcntal, Inc Dated= o� page of <br /> `-� 4005 Nora,Wilson Way Stocklon,Carllornla 95205 (209}467 1006-Fax(2053)467 11 f0 <br /> Chem �'� Project Manager <br /> Tests Required <br /> Phone Number <br /> µ �� LIU) - <br /> -- — Sam lers (Signature) �( Invoice <br /> Project Name <br /> 4qA G, r 6-k(_ �1 J Q <br /> [ l�l/r'41�} '� V AGE <br /> -- - Client ❑ <br /> Sample Location Sdmpfe Type i O <br /> NumberDescnptlon Date Time Water Air Solid No o Notes <br /> cornp Otab <br /> 38872 <br /> 13A x _ >e 38873 <br /> Bass- - 1�-g_ _ 1S'15 5• xSC 7� 38874 <br /> C. _ 15140 — x S X x x x 38875 <br /> 38876 'r <br /> 00 <br /> 38877 , <br /> ,+ y� ( ,gnAlur�leceived y (sign e r 3 8 8/ 8 , <br /> \�+ _ v r <br /> r h y (5 Una fire r TSec ived by (Sign u <br /> note/Time <br /> Rel,ngnrshed by (S+pnalure) Received by Mobile Laboratory for Geld analysis (Signature) balelrime <br /> — �� <br /> U,npalohed by (Signalurc) 57s1elTFme Ilocerved liar Laborelory by <br /> UalelTlme <br /> PA ho I Sill pmen r , r Laboraloty His <br /> ir. 1 r <br /> tc <br /> Special Inainrchon-k "' t.." „ ' In <br /> I hereby at xs the perlarma sol the above Indlested wort, <br /> It <br /> IVA(�ne I <br />
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