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ARCHIVED REPORTS XR0000710
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 XR0000710
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Entry Properties
Last modified
2/15/2019 7:59:02 PM
Creation date
2/15/2019 4:26:41 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000710
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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_ Client �It�n-� � <br /> DEL-TECH SAMPLE CHAIN OF CUSTODY RECORD Address � � - mss--- <br /> Geotechnical Support Services {please prinQ Phone No. <br /> Proj. MgrJContact <br /> 10624 Olive Avenue <br /> Oakdale Calif. 95361 Pink field Copy <br />� White and Yellow-To Laboratory with Samples i <br /> (209)547-8757 Record of Yellow-Return to Client <br /> 1 <br /> PROJECTISITE NAME: , f� im,��, �d.a ANALYSIS REQUESTED <br /> iLap l <br /> PROJECTICONTRACTIPO NO.: <br /> l L.�. <br /> M&OF SAMPLER: REMARKSISPECIAL INSTRUCTIONS <br /> LAB SE ONLY MPLE a m <br /> NUMBER <br /> LAB I.D. fA. DATE TIME O ¢ CON- 1 <br /> U 0 TAINERS <br /> e { <br /> ung <br /> I Ll <br /> RELINQUISHED BY SIGN DATEITIME RECEIVED BY.LSIGNJ DATEITIME _RECEIVED FOR LABORATORY <br /> e BY(SIGN):.-1-i�-�Ai-I� DATEITIME L� 1 <br /> RECEIVED: <br /> COLD AND INTACT OTHER PRESERVATIVE DYES )(No <br /> ❑OTHER: <br /> TURN AROUND TIME: <br /> f SNIPPED VI FED X ❑UPS pOTHEFI:�±f � - SHIPPING R NO.: 074-Hr 02-Day 05-Day '}ay <br />
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