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ARCHIVED REPORTS_XR0012741
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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501
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3500 - Local Oversight Program
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PR0545337
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ARCHIVED REPORTS_XR0012741
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Entry Properties
Last modified
2/11/2020 4:50:47 PM
Creation date
2/11/2020 11:57:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012741
RECORD_ID
PR0545337
PE
3528
FACILITY_ID
FA0003629
FACILITY_NAME
ARCO STATION #434*
STREET_NUMBER
501
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
03119028
CURRENT_STATUS
02
SITE_LOCATION
501 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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CHAIN OF CUSTODY RECORD <br /> Client name 8C Log Number <br /> J—ob number <br /> Proleet no e I �� Analyses required <br /> �� . <br /> 3 <br /> Projtet manapar 5mmpler(sl // ^ <br /> //// ^� J L <br /> } C4 <br /> T <br /> Sample <. <br /> P Date a a Ti .' <br /> e Composlte ' 9 <br /> s'. number sampled sompIL Sample description Nun bar `a�` <br /> or <br /> it Glob - of 40) Remarks <br /> { <br /> j <br /> I <br /> Signature Company <br /> Date Time <br /> nalinqufehed by <br /> " S <br /> i <br /> Received by 1 °in7l/t tYG G,; <br /> Relinquished by <br /> l <br /> Received by E <br /> e <br /> _ aF <br /> Relinquished by <br /> Received by <br /> BROWN AND CALDWELL Analytical Laboratories <br /> Note: Samples are dFsearded 30 days atter results arc reported <br /> �1 <br /> ❑1255 Powell Street, Ema{iryviIle,CA 94608 (415) 428.2300 unless other arrangements are made. <br /> ❑373 South Fair Oaks A 1enue, Pasadena. CA 91105 (213) 601.4655 Hazardous samples Will be returned to client or disposed <br /> of at Client expense. e <br /> a _. <br />
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