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ARCHIVED REPORTS XR0000703
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 XR0000703
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Entry Properties
Last modified
2/15/2019 10:02:47 PM
Creation date
2/15/2019 4:23:32 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000703
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 CUSTOD ECORD <br /> =-' - GeoEnvironmental, Inc. Date t -- Page of— --' <br /> : - --�~ of Nor7henr California <br /> 1803 West March Lane,Suite A-Stockton, California-95207-(209)956.0264-Fax(209)956-0700 <br /> Client 4rA C , Project Manager Tests Required <br /> C lhq <br /> Phone Number <br /> Zo -- 56 z b <br /> Samplers: (Signature) invoice: <br /> AGE <br /> Project Name Client ❑ <br /> FvdOn/ <br /> r I <br /> Sample Location Sample Type .Noof <br /> Date Time Water Solid 80495 <br /> Number Description comp. crab. Air Conts. r <br /> ' d �- 80496 ' <br /> Px:r,f7 <br /> P5 1,1aZ4_F �� ;' ��, zo- L4 -z�)�y7 �l',rs X <br /> ti s�rr�'neD I 80497 <br /> 3l 5 10 Yi <br /> 015 o5o* to X -$0498 ' <br /> (�jRr45� a 0 4 g 9 <br /> r � <br /> r ' :t. $0900 ' <br /> I '? -Z0 <br /> ffnquis e y: ( igrnature) ecerve y: ignature bate/Time <br /> ST09 R� c <br /> flail uish by: ( gnature). Rec 'ved by: ($ignature3 at Time <br /> R 'elinquished by: (Signature) Rec ed by Mobile Laboratory for field analysis:(Signature) 0 telTime <br /> Dispatched by: (Signature) Date/Time Received tot Laboratory by: DatelTime <br /> Method of Shipment: CW ' Laboratory Name <br /> Cflg( hf- <br /> Oao THEn <br /> Special instructions: VO METAL Ol hereby authori a the performance of the above indicated work. <br /> V 11 1 <br /> GOOD CONOfTlON APPROPRIATE <br /> ---fUD SPACE Ef CONTrh!NERS <br />
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