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ARCHIVED REPORTS XR0000686
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 XR0000686
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Entry Properties
Last modified
2/15/2019 7:29:01 PM
Creation date
2/15/2019 4:04:29 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000686
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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CHAIN OF C <br /> Advancers USTOANECORD <br /> :. <br /> GeoEnvironmental, Inc Date Page of 7 .� <br /> 837 Shaw Road Stockton California- 95215- (209)467-1006 - Fax (209) 467 1116 <br /> Client �p Project Manager Tests Required <br /> _ V <br /> Phone Number c <br /> Samplers (Signature) �' Invoice <br /> Project Name U AGE <br /> Client <br /> � <br /> Sample Location Sample Type <br /> Number Description <br /> Date Tlme comWateerrab Air Solid No <br /> Notes <br /> P <br /> ir► inla3 70 <br /> <j Z- <br /> , • �� fro z <br /> 7 PL. <br /> e inqu s e y (signature) Receive by (Signature) Date/Time <br /> Re in Aed by ( mature) Received by (Srgnalure) � DatetTime <br /> I / Elft <br /> R Ern ursd bgnat e) Received by Mobile laboratory for field analysis (Signature) Date/Time <br /> TiAT <br /> Dispatche y ($ nature) Date/Time He ve r or ry <br /> Date/Time <br /> Method of Shipment Laboratory Name <br /> Special Inslrucdons 1 hereby a thorzze the performance of the above Indicated work <br />
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