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ARCHIVED REPORTS XR0003996
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 XR0003996
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Entry Properties
Last modified
11/6/2019 10:08:44 AM
Creation date
11/6/2019 9:52:07 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003996
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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r r r� r� �s ■r r wrr r rr r M lMIM <br /> , � • <br /> Advanced '- CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date q ff Page I of j <br /> of Nonifterrr Calrfornta <br /> 1803 West March Lane Suite A Stockton, California 95207-(209)956-0264 Fax(209)956-0700 <br /> Cllen# Project Manager <br /> M S lV �f u i tq MIK' i f Tests Required <br /> Phone Number V47 <br /> ��aq) q56-0.16 Ll <br /> Samplers (Signature) Invoice <br /> Project Name A yr t -t A Y-1 y S 15AG E <br /> Client � <br />� Sample Location Sample Type <br /> Date Time No of <br /> Number Description Water Air Solid Conts Notes <br /> Comp Grab <br /> ML,' - 1q� q6 -q�q6 G��xx� X z <br /> 11;q0 Z X <br /> 11 :30 2- X - 3 <br /> RugW' -q� <br /> r lO <br /> e mquis e y (Signature) eceive y ( rgnature Date/T�i e <br /> Relinquished by (Signature) 4Rerewd <br /> (Signature DatelTome <br /> "d <br /> Relinquished by (Signature) Mobile Labor tory for field analysis (Signature) Date/TirAe <br /> Dispatched by (Signature) Date/Time Received for Laboratory by DatelTrme <br /> Method of Shipment Laboratory Name <br /> C14 at«r Al A-i <br /> Special Instructions I hereby authorize the performance of the above indicated work <br /> ,rr _ /�v` �� <br />
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