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ARCHIVED REPORTS XR0000692
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 XR0000692
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Entry Properties
Last modified
2/15/2019 8:45:35 PM
Creation date
2/15/2019 4:12:34 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000692
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
Scanner
WNg
Tags
EHD - Public
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Advanced CHAIN OF USTODY RECORD o <br /> =�= GeaEnvii•onmcntal, Znc. �[y 3` Datta �� Page of L Q o <br /> P il-� o <br /> 4085 North Wisvn Wny S1odclui,CNhlarr•ra 95205 (209)467 '00B Fax(209)4671118 � <br /> m n <br /> Client Project Manager CD CL <br /> Project <br /> C. oy- Tests Required <br /> Phone Number <br /> Samplers (Signature) �� Invoice <br /> project Name AJ T .- �/��.� �,/ /� AGE <br /> Cfient El <br /> /4 <br /> Sample T / r <br /> Sample Location P —yam No of -< <br /> Number Description Date Tut1a Waley �{ Sajid Cants �"C�/�� / /��/, Notes -� <br /> f `J Comp Grab f/ r a <br /> V)7 - 5"x• 8 -- /3,Q� /Z, Y(� <br /> 05bilou 13, <br /> t <br /> - G 9 <br /> ac o <br /> CD <br /> c� <br /> cn o <br /> W o <br /> N n <br /> — � m <br /> CD <br /> e <br /> e n ws efi it 6 gnatire eoFive y ( rgnalvre <br /> tset Time <br /> Fieirnqulated b/ S� nnwre atefT <br /> ( 9 ) Received by (Signature) -Me <br /> Lie- VK/co <br /> Rel3nau�ishud t,y (Signature) iReceived by MDbrle Laboratory for held analysis (Signature) �LO DatefTirne <br /> Dlfpalched ty (Slgnalure] Dale(Tirno Race i d for Labor lory�y, tafTima <br /> yds <br /> G�e -7zU <br /> Method of Shipm em Laboratory NameCD <br /> o <br /> 6pecial Ir1ltr�cligne I hereby authorize the perrormence of the above mark v <br /> o <br /> CrP <br />
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