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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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C <br /> Arlvonc ed CF IAIN OF CUSTODY III-CORD <br /> Dale_/23/a2_ Pae <br /> 837 Shaw Road Stocklon California - 9 _ _ <br /> 5215 - (2G�) 467 1GG6 Fax (2GJ) 467 1118 <br /> _Ghent — ,, —� Proiect Manaupr — - --� <br /> Tests Hoctuirect <br /> 'Pone Number <br /> E[ <br /> 5 pier,, (Signature) '�� r '3 lnvnlz,a <br /> Project Name � `�u � � � AGE [,�t <br /> — _ �. Ll ,v� w 1 x �c7 Chant j <br /> �— j <br /> Sample Type <br /> - �- -- _--� -Sample \l Location �_ j yp <br /> Date Time Water _— ---- SoNci NO of t� <br /> Ntimber Description Alf Corps Notes <br /> comp (3rai� <br /> r <br /> 1,6 <br /> L - ----- ------ - <br /> n s a ( ign erre- - Rage vadTiy $tgnehire- <br /> R quash d b V <br /> Signator Received by (Signature) <br /> Relingt0s6 ad by Slg a—Ime) liaaalyod by Mobile I aboiatory tot fiaid arnai fnia (8ignahrfa) r)ai�/Tlrr. <br /> f)ispalOwd by (Signattue) _ — W Date/Time Received t ah r or r gdiu/7rnrn <br /> Method of Shipment Y I aboralory $M <br /> Spa0a11nsuuctions I h8reby aurlrorize the plrlormance of tale dbuvd kikliLuiod troll, <br />
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