My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
ARCHIVED REPORTS XR0000703
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
C
>
CAPITOL
>
6421
>
2900 - Site Mitigation Program
>
PR0522496
>
ARCHIVED REPORTS XR0000703
Metadata
Thumbnails
Annotations
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
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
81
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
NNW . <br /> Advanced CHAIN OF CUSTODYCORD <br /> I { <br /> GeoEnvironmental, Inc. Date '��'�f� Page � of� <br /> n NoahP171 Cali ar7tia <br /> 1803 West March Lane, Suite A-Stockton,Califonia-95207-(209)956=0264-Fax(209)956-0700 <br /> Client Project Manager <br />} C'14 C01711 Tests Required <br /> L <br /> Phone Number <br /> 261 ci5L - t <br /> Samplers; (Signature) invoice: <br /> i <br /> Project Name �� r( 1> >� % > AGE R�Client ❑ <br /> Sample Location Sample7ype Solid No. of <br /> Number Description Date Time Water Air Conts. <br /> Comp. Grab. 1 <br /> i <br /> t <br /> P( o- ra �- 55-4e X <br /> 1 ` <br /> bi-to <br /> f I 0tG1 S�r 41; . <br /> EIAI <br /> e ingws a y: ( ,gnature eceive y: (Signature) t)ate/Time <br /> O-A omw 16 NT )�ND A PD [� •zy 5:cp <br /> Relinquish by: ( ignature) Received by: (Signature) ate/Time I�/��' <br /> �A fl 'r, q <br /> Relinquished by: (Signature) Rece ed by Mobile Laboratory for field anatysis: (Signature) atefTime <br /> aispalched by: (Signature) late/Time Received for Laboratory by: DateAlme <br /> Method of Shipment: �� r] .4 t/4 CA Laboratory Name g3!9� C ot)�- am r <br /> .�- QWg.1Jj of N- �/-t <br /> ca <br /> Special Instrudtiohs:" 7 uI hereby authan a the performance 61 the above Indicated work. <br /> WAS <br /> h11�IILS aTHE <br /> i _ <br /> MIMI V - UP 0FRATE <br /> k}rte Si ACF ASSEN C0NTA#t'-E11S <br />
The URL can be used to link to this page
Your browser does not support the video tag.