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ARCHIVED REPORTS XR0003983
Environmental Health - Public
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EHD Program Facility Records by Street Name
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L
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LODI
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204
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3500 - Local Oversight Program
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PR0544962
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ARCHIVED REPORTS XR0003983
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Entry Properties
Last modified
11/6/2019 10:09:05 AM
Creation date
11/6/2019 9:42:16 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003983
RECORD_ID
PR0544962
PE
3528
FACILITY_ID
FA0003651
FACILITY_NAME
ARTS & ARTISTS
STREET_NUMBER
204
Direction
E
STREET_NAME
LODI
STREET_TYPE
AVE
City
LODI
Zip
95240
APN
04719102
CURRENT_STATUS
02
SITE_LOCATION
204 E LODI AVE
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\wng
Tags
EHD - Public
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CHAIN OF CUSTOD ECORD <br /> ti &oi — gical Audi# Services Inc. �_ ,�q� 7 s Date Page of <br /> — =�� En�irt�meata Prof�srona�Fs <br /> =�wti11111111�w <br /> 1803 West March Lane, Suite A-Stockton,California-95207-(209)858-02B4 <br /> Client Project Manager Tests Required <br /> Vic ('I Qry-eh <br /> Phbne Number <br /> coq • 4� 6- 0 �6+� f-'r <br /> Samplers: (Signature) �� Invoice: <br /> GeoAudit <br /> Project Name Ar'r5 + Arti s� <br />� f � Client ❑ <br /> Sample Location Sample Type No. of '�1 / <br /> P Date Time Water Solid Q Notes <br /> Number DescriptionComp. Air Conts. <br /> Grab. <br /> vw- )/12,1 -43 /.-I/ I��r 7-�r �-. 5'p <br /> WW- <br /> 1 <br /> Ww', 4Y / 33D 3'f?0p X <br /> VW-r/, 5= f7 <br /> I <br /> Relinquished y: (Signature) Received y: (signature) a }z' Date(Time <br /> Relinquished by: (Signature) Received by: (Signature) Date ime <br /> I <br /> Relinqu�s y: ignature) Received by Mobile Laboratory for field analysis:(Signature) Date/Time <br /> ispatched b re Date/Time Received for LaboAatory b ' Dat ITime <br /> f <br /> 2-11 <br /> rrZ�0 <br /> Method of Shipment: a at r Name <br /> 1-7 5 <br /> Special Instructions: I hereby authorize the performance of the above indicated work. <br />
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