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ARCHIVED REPORTS XR0000671
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 XR0000671
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Entry Properties
Last modified
2/15/2019 6:40:23 PM
Creation date
2/15/2019 3:24:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000671
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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188111 KELLY ROAD NAPA,CA 94558 (707)256 4400 FAX(707)225-1001 PAGE y OF t <br /> Caltest SAMPLE CHAIN OF CUSTODY <br /> rR-0ECTNAMEJI PROJECTNUMBER _ Po* LAB ORDERA <br /> Al7A>F..7f17[T.#L�lRQith1`QiIY09Ui58 CC90158 <br /> CLIENT REPORT TO (rvtle one) r <br /> Caltest Analytical Laboratory Charlya Heang ANALYSED REQUESTED <br /> MAI UNG ADDRESS STATE IIP to <br /> F- <br /> ti <br /> 1895N Kelly Road CA 94558 -z <br /> TURN AROUND TIME <br /> BILLING ADDRESS ATTN Q U <br /> } N U <br /> Same Same qSTANDARD <br /> PHONEk �FAXPHONF' ISAMPLEA(PRINT S SIGN NAME) O <br /> LU <br /> 707!258 4000 707!226-1001 CLIENT Y <br /> [:]ftL1511 <br /> U J J c <br /> z Z DLIC DATE u <br /> OLL <br /> r <br /> CONTAINEA f.y U <br /> GALTESI DATE TIME SAMPLE TYPE! PRESERYATEVE SAMPLE 1iaENTEFfCATION!SITE F- ab <br /> LADE SAMPLED SAMPLED MATRIX AMOUNT REMARKS w <br /> CL To <br /> UJ N CL CJ - <br /> 09 0502 1310 FE AL NONE EFFLUENT FLAG CITY CHEVRONX Please include P 0 NUMBER, <br /> PROJECT NUMBER,and SAMPLE w <br /> ID/SITE on REPORT and INvoiCE <br /> Please RETURN COOLER <br /> s <br /> z <br /> �Cq <br /> 3 <br /> RELINQUISHED BY DATEITIME RECEIVED BY RELINQUISHED BY DATFITIME RECEIVED 6Y <br /> STmplw VJC MICRO BIQ AA 5V VOA 'MATRIX AQ=Aqueous Nondr*tkang Water <br /> pH7 YIN TEMP EAkE3+ YAi TNTACY rirL Dgas%d Metals;FE-Low RLL*,Aqueous <br /> Nondrinking Water Digested Metals DW- <br /> r BD 8M, WG M $uBCDNTTIACYiARNAME, DrinlangWaterSL-Sod Sludge Salad FP- <br /> Cc µ By voa ALTA ANALYTICAL Lk806pT©RY <br /> ^CONTAINER TYPES AL-Amber LRsr AHL- <br /> Soo m!Amber PT.Pint(Plastic) OT=Quart <br /> m SIL FIR — PT — QT v VOA (Plastic) HG-H&VGallon(Plaslir) SJ-Sa1Jar <br /> ba70 HvkttR Mathews Parkway B4-40z SACT BT-Brass Tube VOA-4DmL <br /> t mwM Hr904 WH EI Domjlo dills,CA 95762 VOA,OTC OtharType Oomamer <br /> PIL wcO ;iso, NeOH HCL PH(916)983.1640 FAX(91&}933-0940 <br /> A EH M F <br /> Project 22791 Page 10 of 11 <br />
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