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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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3500 - Local Oversight Program
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PR0544481
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Last modified
5/20/2019 3:17:49 PM
Creation date
5/20/2019 3:06:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0544481
PE
3528
FACILITY_ID
FA0005127
FACILITY_NAME
ELLIS CAR WASH
STREET_NUMBER
820
Direction
S
STREET_NAME
CHEROKEE
STREET_TYPE
LN
City
LODI
Zip
95240
APN
04742005
CURRENT_STATUS
02
SITE_LOCATION
820 S CHEROKEE LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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GeoAnalytical Laboratories, Inc. <br /> 1031 Kansas Ave., Suite C Phone (209) 572-0900 <br /> Modesto, California 95351 Fax #(209) 572-0916 <br /> CHAIN OF CUSTODY <br /> 0 <br /> 195 <br /> Client CONDOP— Z--LL2 �Uczt Phone <br /> Address CC to: <br /> Zip <br /> �#w Tm6! 0j/Y C9 e Dpi 6r t.1 <br /> PROJECT IDc No. ANALYSIS A ✓V of —06Z <br /> of <br /> con <br /> SAM PL �BY ( gnal fain- <br /> ers y/ REMARKS <br /> sample V <br /> type Sample Location <br /> Date T e Grab Comp. <br /> z";5 x n� i / <br /> i� S5-lot -r lkv kl <br /> nquished by(spa, e): Date Timep R Eby(s' ature Date Time <br /> d+ <br /> R ' quished by (sign re): ate Time Received by (signaturey, Date Time <br /> elinquished by(signature): Date Time Received by(signature): Date Time <br /> Relinquished by (signature): Date Time Received by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> Site Time: Driving Time: <br /> Start: Finish: Total Hours: Start: Finish: Total Hours: <br /> Garoli Graphics(209)527-3667 <br />
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