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ARCHIVED REPORTS_XR0004135
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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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_XR0004135
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Entry Properties
Last modified
2/12/2020 3:48:23 PM
Creation date
2/12/2020 9:09:09 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004135
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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tl• t� � � � � � l• � i• i• i• � i• i• i• i• i• l• <br /> Advanced CHAS OF CUSTOPRECORQ <br /> GeoEnvironment al. Inc. pate zv( Page <br /> 837 Shaw Road -Stockton, California-85215-(209)467 1006- Fax(209)467-1118 O 7 — /P � f� <br /> �Client t Pro ect Manager``yU1�� � Tests Required <br /> )Pittone NurAW <br /> Samplers (Sign re) invoice <br /> Project NameAGE <br /> <V:�V%1� � , ' l C Client <br /> Sample Location Sample Type Solid No of <br /> Number Description date Time Water Air Conts <br /> - �N Notes <br /> Comp I Grab <br /> k'. <br /> N6C= <br /> nq s rg lure stews y igna(ure Date/Time <br /> s f� <br /> Relinquished by ig ure) Received by (Signature) Date/Time tL <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date(Time <br /> Dispatched by (Signature) Date/Time Received far Laboratory by J Date(rrm <br /> Method of Shipment /\ ; Labo ory N <br /> Cak <br /> Special instructions I hereb authorize the dorm rice of a above indicated work <br />
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