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FIELD DOCUMENTS
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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CHEROKEE
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2900 - Site Mitigation Program
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PR0522056
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Last modified
5/17/2019 3:24:27 PM
Creation date
5/17/2019 2:48:06 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0522056
PE
2950
FACILITY_ID
FA0015023
FACILITY_NAME
USA GASOLINE #3502
STREET_NUMBER
35
Direction
N
STREET_NAME
CHEROKEE
STREET_TYPE
LN
City
LODI
Zip
95240
APN
04318003
CURRENT_STATUS
01
SITE_LOCATION
35 N CHEROKEE LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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Billing InA <br /> rmation: — Alpha Analytical, Inc. <br /> Name �%' chi "�,c1r '31 255 Glendale Avenue,Suite 21 Page# of ' 3385 <br /> r" Sparks,Nevada 89431-5778 <br /> Address �1�) �w' �w(�. J <br /> City,State,Zip Alak-'115" �- Phone (775)355 1044 Analyses Required <br /> Fax (775)355-0406 Y q <br /> Phone Number Fax <br /> Client NameQ L J P.O.# Job# t <br /> Address -7 r PWS# DWR# <br /> City,State,Zip (/ p{ CA- Phone# Fax# <br /> Maw* Office Use Sampled by- Report Attention / ,r Total and type of CJ <br /> Time Date Only �C t` �; iw <br /> Sampled Sampled See Key y containers � � t f•, <br /> Below Lab IDNumber Sample Description '*See below REMARKS <br /> 102�2 _ 1. 17 <br /> /5 nes n' <br /> 1 �a <br /> - PF 0i��� <br /> ADDITIONAL INSTRUCTIONS: <br /> Signa .re Print Name Company Date Time <br /> Relinquished by • A ' ,, <br /> Received by <br /> ppff <br /> Relinquished by <br /> Received b Q CA <br /> n 2I/c 12A 5 <br /> Relinquished by C <br /> Received by <br /> *Key: AQ-Aqueous SO-Soil WA-Waste OT-Other **: L-Liter V-Voa S-Soil Jar 0-Orbo T-Tedlar B-Brass P-Plastic OT-Other <br /> NOTE: Samples are discarded 60 days after results are reported unless other arrangements are made. Hazardous samples will be returned to client or disposed of at client expense. The report for the analysis <br /> M tha nhm/c,camnlac ie annlirahlo nnly to thnca camnlac raraivarl by tha lahnratnni with this rnr, Th,-liahilihi of tho lahnrntnni ie limitari to tho mmniint nairl fnr tho r—ri <br />
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