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ARCHIVED REPORTS XR0000649
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 XR0000649
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Entry Properties
Last modified
2/15/2019 8:14:48 PM
Creation date
2/15/2019 3:09:59 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000649
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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RD <br /> ( Advanced CHAIN �O,F� CUSTOD RE Q <br /> `-'�3 L' Pa --5— of <br /> -� - GeoEnvironmental, Inc Date Page <br /> 837 Shaw Road Stockton California- 95215 (209) 487 1006 Fax (209) 467-1118 <br /> Client s`C � .^ I` Promo ee5 Manage <br /> f Tests Required <br /> t.L � ( l/ r <br /> hone N tuber <br /> Samplers (Signature) Invoice <br /> Project Name �, 7 AGEclient <br /> [ <br /> Sample Type -`' <br /> Sample Location Date Time Water Solid No of " Notes <br /> Number Description Air Conts e <br /> Comp Grab <br /> N Y-. <br /> LPF <br /> 13 <br /> ebnq rs e (S nal e) ecerve y rgnature T3 te4�rle <br /> '2t7G� <br /> Relinquished by (Signature) ICt° Received by (Signature) Dat <br /> GOOD CONDITION$ APPROP123A78 <br /> Relinquished by (Signature) DLCHLORTNAThD l]+1I A9 MIR oratory far field analysis [Signalute) �'�� � ❑ate(rirrro <br /> ' oA D G METALS I GYMR <br /> Dispatched by (Signature) a Received for Laboratory b Date/Time <br /> ter <br /> Method of Shipment Laboratory Name c7,-ao,V� <br /> L <br /> Spacial Instructions J( f� l hereby authorize the pertorman of the above 1ndL Med work <br />
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