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ARCHIVED REPORTS_XR0003562
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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K
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KETTLEMAN
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401
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3500 - Local Oversight Program
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PR0545335
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ARCHIVED REPORTS_XR0003562
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Entry Properties
Last modified
2/11/2020 6:47:26 PM
Creation date
2/11/2020 11:18:53 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003562
RECORD_ID
PR0545335
PE
3528
FACILITY_ID
FA0003603
FACILITY_NAME
TESORO (SPEEDWAY XP) 68152
STREET_NUMBER
401
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
04513019
CURRENT_STATUS
02
SITE_LOCATION
401 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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unramar Inc. BEACON <br /> CHAIN OF CUSTODY REPORT <br /> umarnar <br /> Beacon Station No. Sampler(Print Name) Date Form No. <br /> ANALYSES of <br /> SP <br /> Project No. Sampler(Sign tura) <br /> U3 <br /> -513- 7X <br /> a 1 NvProject Location Affiliation <br /> N o <br /> ro .0 U <br /> Lu 2: 2 0 <br /> Sample No./Identification Date Time Lab No. z°I REMARKS <br /> 7DO <br /> .Z 3D <br /> A4 1A1-J <br /> SSS <br /> 01) <br /> _ od <br /> Relinquished by. (Si ) <br /> Date Time Received by: (Signature/Affiliation) Date Time <br /> gnature/Affiliation <br /> ehnquished by: (Signature/Affiliation) D to Time Receiv d by: (Signat relAffili Date Time <br /> Reli quished by/ (SignaturelAffiliation) Date Time Received 452est <br /> ation) D e /Time <br /> q)(70 L) <br /> Report To: Bill to: R INC. <br /> hird Street <br /> Hanford, CA 93230 <br /> Attention: <br /> WHITE: Return to Client with Report YELLOW: Laboratory Copy PINK: Originator Copy X2.90031+90 <br />
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