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ARCHIVED REPORTS XR0000682
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 XR0000682
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Entry Properties
Last modified
2/15/2019 9:12:52 PM
Creation date
2/15/2019 3:58:17 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000682
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
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EHD - Public
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( Advanced CHAIN 9F CUSTODY RECORD <br /> YkiGeoEnyironmental, Inc. DatePage ---L of_ <br /> 837 Shaw Road- Stockton, California- 95215-(209)467-1006-Fax(209) 467-1118 <br /> Tient Project Manag , <br /> � Tests Required <br /> Phone Number <br /> C);�') q6 <br /> Samplers (Signature) Invoice <br /> Drolect NameT571aaA-�L <br /> AGE Q' <br /> (�A (�J-4 6-1yo Lm—er Client ❑ <br /> Sample Location Sample Type Solid No of <br /> Number Description Date Time Water Air Conts Notes <br /> Comp Grab <br /> \4 1 <br /> 0�z ;r"4 19 <br /> I <br /> I I <br /> e inq a ignature ac e y atura atelTime <br /> h <br /> RelintshBd b 5i at re) R Rece ed by (S nature) DatefTlme <br /> t <br /> - L.A A Z 44"101 e's7k-" <br /> Rehn wished by (Signature) Rece1 a by Mobile Lagratory for field analysts (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Received far Laboratory by DatetTime <br /> Method of Shipment La oratory Ne a <br /> � a <br /> Special instructions I hereby au rze thi performance of the above Indicated work <br />
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