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ARCHIVED REPORTS_XR0013041
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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2500
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3500 - Local Oversight Program
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PR0545420
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ARCHIVED REPORTS_XR0013041
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Entry Properties
Last modified
3/5/2020 5:54:15 PM
Creation date
3/5/2020 5:00:17 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0013041
RECORD_ID
PR0545420
PE
3528
FACILITY_ID
FA0003815
FACILITY_NAME
TESORO (SPEEDWAY) 68154
STREET_NUMBER
2500
Direction
W
STREET_NAME
LODI
STREET_TYPE
AVE
City
LODI
Zip
95240
APN
02740006
CURRENT_STATUS
02
SITE_LOCATION
2500 W LODI AVE
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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ENGINEERING INC. �q S I.D.# 6 5 <br /> X 5u 8084 OLD AUBURN ROAD <br /> RCE#27411 Lic.#53`7901 CITRUS HEIGHTS,CA 95610 <br /> (9 16)723-7645 J013 7} <br /> ''LLIC.#537901 <br /> 9-710 - F7 CHAIN OF CUSTODY c2o4";L P.0 # <br /> JOH NAME: L� A �a5 , LO\-� L------ — LAB ,. I'a,f rte <br /> PROJECT MANAGER: K i3e vi np SAMPLES COLLECTED BY: ul" <br /> SAMPLE 'TYPE, <br /> - SAMPLE TYPE ANALYSIS <br /> oSAMPLE LOCATION DATE TIME NO. CONTAINER(S) REQUIRED <br /> G SOIL AIR WATER <br /> x 1-77 74 <br /> 1-747S- <br /> 1.7 7� <br /> r 1 n 3} - <br /> ea'�c <br /> HE <br /> a <br /> PRINT NAME AFTER SIGNATURE <br /> RELIN UISHFD BY: / RECEIVED BY: DATE/'TIME <br /> 'Q.c-- s� r �( <br /> RELINQUISHED BY: RECEIVED BY: DATE/'TIME: <br /> RELINQUISHED BY: RECEIVED BY: DATE/TIME <br /> RECEIVED FOR LABORATORY BY: DATE/'TimE <br /> AIF1,110I) OF �I11P&IEN <br /> 07 y �� 3 g ) <br /> DIaPOSITION: <br /> �1 <br /> STORAGE ❑ REFRIGERATOR ❑ FREEZER <br /> N AROUND SECURED <br /> L-] 24 HOURS ❑ 3 DAYS ❑ 1 WEEK 4?r2 WEEKS �� � ❑ ❑ <br /> YES NO <br /> NOTE:: PLEAS[-' HAVE' EACH DATA SHEET SIGNED BY CHEMIST, <br />
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