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ARCHIVED REPORTS_XR0003065
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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1301
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3500 - Local Oversight Program
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PR0545342
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ARCHIVED REPORTS_XR0003065
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Entry Properties
Last modified
2/12/2020 3:38:31 PM
Creation date
2/12/2020 8:56:11 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003065
RECORD_ID
PR0545342
PE
3528
FACILITY_ID
FA0000392
FACILITY_NAME
FLAMES LIQUOR
STREET_NUMBER
1301
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95242
APN
03104030
CURRENT_STATUS
02
SITE_LOCATION
1301 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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• <br /> CHAIN OF CUSTODCORD , <br /> � Advanced � <br /> Page of <br /> GeoEnvironmental Inc. Date ��`� ��� <br /> 837 Shaw Road- Stockton, California- 95215 - (209)467-1006- Fax(209)467-1118 <br /> Project Manager Tests Required <br /> Client `[~ "'Z Y'Gfi �,a-, <br /> one Number <br /> �ZoC7) LJUI- <br /> Samplers (Signature) ,P Invoice <br /> V^ �i <br /> 1 AGE <br /> Project Name ; U� +S Client C-] <br /> /� N <br /> Sample Location Date Time Sample Type Water Solid No of Notes <br /> Number Description Comp Grab Air Conts <br /> LOLN IX. <br /> plun1 ' ? o5&-2, <br /> ur y �(Sna ture) Received y ignalure Date(T+m/a <br /> owl(II( (&3 0 <br /> Re inquished bynature) Received by (Signature) Datslrime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) / LSI Date/Time <br /> Dispatched by (Signature) Date/Timo Received for Laboratory by 11 Oat me <br /> .1� <br /> Method of Shipment Lob or{i <br /> he�7�Jory Nam¢, <br /> p C as i eby lhonza the porta mance , the above Indicated work <br /> Special In" <br /> structrons <br />
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