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ARCHIVED REPORTS XR0003994
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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L
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LODI
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204
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3500 - Local Oversight Program
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PR0544962
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ARCHIVED REPORTS XR0003994
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Entry Properties
Last modified
11/6/2019 10:09:08 AM
Creation date
11/6/2019 9:50:47 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003994
RECORD_ID
PR0544962
PE
3528
FACILITY_ID
FA0003651
FACILITY_NAME
ARTS & ARTISTS
STREET_NUMBER
204
Direction
E
STREET_NAME
LODI
STREET_TYPE
AVE
City
LODI
Zip
95240
APN
04719102
CURRENT_STATUS
02
SITE_LOCATION
204 E LODI AVE
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\wng
Tags
EHD - Public
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s = = M M = I = 11 = M <br /> Advanced CHAIN OF CUSTOD RECORD <br /> lo `�� Page e <br /> GeoEnvironmental, Inc. Date g --L af--L- <br /> " of Nin!hem C(ihfo w <br /> 1803 West March Lane Suite A Stockton California 95207 (209)956-0264 Fax(209)956-0700 —1,515A &E71S3L <br /> Protect Manager <br /> Client M N K w th tic-K) h-eTests Required <br /> Phone Number 1� <br /> (-oq) 15 6 - o;-6�- <br /> Samplers (Signature) Invoice <br /> ^ 40, AGE <br /> Protect Name A Y,-r + W015 Client ❑ <br /> Sample Location Date Time Water Sample Type Solid No of Notes <br /> � <br /> Number Description Comp Grab Air Conts <br /> f4�rlz <br /> Re tnr qurshe� rte( + nature Ro e y re, <br /> e /43_3�_ Palo/Tyne <br /> Ccs <br /> elinR quashed by (Signature) 44,reeived by (Sig alure) Dale(Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for Held analysis (Signature) Date[Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Date rime <br /> Method of Shipmentnn Laboratory Name <br /> Gly ov*ror GIT- g e�,✓ � el �t�.(In�Q W (Am bill <br /> Special Instructions I hereby auttjhofizee the performance of the above indicated work <br /> ICF116 31 PRESERVATIVE <br /> GOOD CONDITION APPROPRIATE J <br /> ul=en CPAPC AlI MlT rn►ITeILIroe <br />
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