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ARCHIVED REPORTS XR0000644
Environmental Health - Public
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EHD Program Facility Records by Street Name
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C
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CAPITOL
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6421
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2900 - Site Mitigation Program
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PR0522496
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ARCHIVED REPORTS XR0000644
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Entry Properties
Last modified
2/15/2019 6:43:17 PM
Creation date
2/15/2019 3:03:38 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000644
RECORD_ID
PR0522496
PE
2957
FACILITY_ID
FA0015317
FACILITY_NAME
FLAG CITY CHEVRON
STREET_NUMBER
6421
STREET_NAME
CAPITOL
STREET_TYPE
AVE
City
LODI
Zip
95245
APN
05532024
CURRENT_STATUS
02
SITE_LOCATION
6421 CAPITOL AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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0 9 CHAIN OF CUSTODACORD- <br /> Advanced <br /> GeoEnvironmental Inc Date Page �-O <br /> 837 Shaw Road - Stockton, California 95215 (209) 467 1006 Fax (209) 467-1118 <br /> Client <br /> Project Manager Tests Required <br /> I <br /> Phpne Nuqtt7r, <br /> Samplers (Signature) / Invoice <br /> AGE <br /> Project Name Client ❑ <br /> Sample Type <br /> Sample Location Solid Notes <br /> Number Description Date Time Water <br /> cafiAir Contip Grab � <br /> r V 9 W <br /> I Z) � <br /> Y 1f <br /> Data ime -- <br /> eiinqui e y i atu ) Receivedy (Signature) R <br /> Reiinquished by {Signature) Received by (Signature) DatelT�me <br /> Relinquished by (SLgrnatute) Received by Mobile Laboratory for field ana4eis (Signature) Datefftme <br /> Dispatched by (Signature) Date/Time Rec d 5tr aboratory by atalTtme <br /> Method of Shipment Al C— <br /> Laboralory Name r <br /> Special 4nsttuchons �� /i �/, <br /> 1 hereby authorize the performance f the above indicated work <br />
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