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ARCHIVED REPORTS XR0000672
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 XR0000672
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Entry Properties
Last modified
2/15/2019 6:13:55 PM
Creation date
2/15/2019 3:24:56 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000672
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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• i ! _ <br /> Brooks Rand Ltd. Chain of Custody Record Pagel—od— <br /> Client a-mail addressa ,� Shi to Brooks Rand Ltd. <br /> 6 <br /> Contact PO# 3950 Avenue NW <br /> Address 1&3-7 sA l w R ra,)o Sampler's signatures Seattle, WA 98107 <br /> S i sic 70^J C9 X S � 1� 206 632 6206 <br /> 206 632 6017 fax <br /> Phone#. '4q W p a Client project ID F)AC, 'r C E x,10,1 e-mail brl@brooksrand com <br /> Fax # n4 / BRL project ID. M CA p l www brooksrand coin <br /> Ew <br /> Collection Miscellaneous Field reservation Analyses required Comments <br /> Sample ID <br /> w <br /> w <br /> L9 a <br /> ly;on v PLO L Q%4- . G E �,c bB,•S33 <br /> 2 M LTH Gfl <br /> 3 <br /> 4 <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 <br /> Shipping carrier LL, I #of coolers <br /> Relinquished by '` Date b/t Time dj;2j Received by Date Time <br /> Relinquished by Date Time iu q� 0610,16- <br /> White: <br /> White: LAB COPY Yellow: CUSTOMER COPY <br />
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