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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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• ! M <br /> l Advanced CHAIN OF CUSTODY RECORD .� <br /> GcoEnvironmental, Inc Date��$oa Page <br /> =- °��',.5 � - C om- co C, ofd n <br /> 4005 North Wilson Way 5locklan,California 95205-(209)467 1006-Fax(209)467 11 T8 w <br /> Cr <br /> Ghent 1 Project Manager <br /> Tests Required ~ <br /> n <br /> Phone Number <br /> Samplers (Signature) !G Irnoice <br /> 10 <br /> Project Name F1 A 0 Ctl ~ <br /> AG T+ � <br /> tJ n Client ❑ <br /> Sample Location *Water <br /> ple Type ,p <br /> / Number Description Date Time Air Solid Conisj <br /> / No rab r <br /> MOSA ' <br /> a -ap Ntorirh�nr I„1e�� g� -a 3'� 41664 <br /> V <br /> *� 13'ys x 416 6 <br /> 41666 <br /> N <br /> u ti, 1 A 1 q'� X41667 <br /> r <br /> E75 q,57Z) }C 41666 <br /> :2 a.> 9cr -D.gaDlS.rao �cv�"- <br /> 41660 <br /> * Y <br /> kt - 0 A � q 1�-s~ k 5 k r 41670 <br /> 0 <br /> e rnquis ie y nature eeerVa y rpna vra 0 <br /> .�_.'111V.�L¢.'1 tele/Yl e <br /> g-o� �l'30 <br /> nelrnqurs ed by (Signature) Received by (Signature) Jt <br /> Datellime co <br /> Relrnr}urshed U7(signature) Received by Mobile Laboratory for held analysis (Srgnefurs) <br /> r]atelTims <br /> 5 d� SfAt <br /> Olapatched by (Signature) Date/time Received for Laboratory y pate/Ttma <br /> Mvilhod of Shipment t LabolaInly Neme 'U <br /> �cih�b.¢)� <br /> 5µeclrrl Instructions I hereby aulhoriza the performance of the abovo Indicated work N <br /> 1 <br /> t <br />
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