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ARCHIVED REPORTS XR0004106
Environmental Health - Public
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EHD Program Facility Records by Street Name
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KETTLEMAN
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2448
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3500 - Local Oversight Program
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PR0544300
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ARCHIVED REPORTS XR0004106
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Entry Properties
Last modified
4/2/2019 4:05:26 PM
Creation date
4/2/2019 3:48:32 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004106
RECORD_ID
PR0544300
PE
3528
FACILITY_ID
FA0003855
FACILITY_NAME
TESORO (SHELL) 68153
STREET_NUMBER
2448
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
05814001
CURRENT_STATUS
02
SITE_LOCATION
2448 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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Uitran Inc. BEAN <br /> BEN <br /> CHAIN OF CUS DY REPORT <br /> Beacon Station No. Sampler(Print Name) D e Form No. <br /> t? �l /cZ CK. .L /.. ANALYSES <br /> Project No. Sampler(S' nature) <br /> 6013- <br /> Project ��atio� �� ��«�� L�� Affiliation C Q vc✓N � 1' <br /> Z 8 rrf l �/ <br /> Lad1 CA �4/4� 4h /ir ncK TA / �w r�� .,J-1 V <br /> X �M-0w ur1M1 <br /> b <br /> Sample No./identification Date Time Lab No. m i-- Q- z° REMARKS <br /> Relinquished by: (Signature/Affiliation) Date Time Received by: (Signature/Affiliation) Date Time <br /> Relinquished by: (Signature/Affiliation) Date Time Received by: (Sig nalu f i iation) _ _�a�e Time <br /> Relinquished by: (Signature/Affilialion) Date Time Received by: Si /ure/Afi lon) Dal/ Time <br /> �. <br /> Report To: A17,14CJ(--, •-- Bill to: GLTRAMAR INC. <br /> b,/A it ��..�,�,".�. fu/,4.,�r l' 525 West Third Street <br /> too Hanford, CA 9/3(230 /p'^ <br /> r', AA 'F Attention: ! `CHHGIZ `-'�r�f r <br /> CA 711 ��Q <br /> WI iITE: Relurn to Client wily Report YELLOW: Laboratory Copy PINK: Originator Copy 32 8003 11w <br />
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