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ARCHIVED REPORTS XR0004113
Environmental Health - Public
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EHD Program Facility Records by Street Name
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K
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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 XR0004113
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Entry Properties
Last modified
4/2/2019 3:57:42 PM
Creation date
4/2/2019 3:50:46 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004113
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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2795 2nd Street,Suite 300 <br /> .�� Davis,CA 95615 <br /> Lab: 530.297.4800 <br /> ANALYTICAL ctc Fax: 530.297.4808 Lab No. Page of <br /> Project tact(Hardvopy gr PDF To): California EDF Report? Oyes No Chain-of-Custody Record and Analysis Request <br /> Company/Address:E:wv i.110--�"k r fleoarMnerdedlxAnd w er9s.cnore <br /> Sampling Company Log Code: Analysis Request <br /> Phone No.: FAX No.: Global 10: o <br /> U <br /> Proj ct Number: P.O. No- <br /> EDP Deliverable o( Y Email Address): m o �+ <br /> �700yj Ob-t vKc.�aQ ,can _ N m O <br /> Proect Name: Sa pler Sign tura: �' m o ;� W o t <br /> Project Address: Sampling contalner Preservative Matrix . 9 k k m �! <br /> 2`�` s W e cw, a m ca m '� = o `o <br /> i t LU <br /> UJ <br /> X c <br /> Sample Designation Date Time a i s z 3 c°n m M ti r. ° w <br /> x x x <br /> Relin wished by: Date Time Received by: Remarks: <br /> k�- ic`I °q : <br /> Relinquished by: <br /> Relinquished by: Date Time R i ad by Laboratory: Bill to: <br /> G frl /e <br /> MWbution: Whits-Lab, Pink-Originator formslcoc 1210011h9 <br />
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