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ARCHIVED REPORTS XR0003986
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 XR0003986
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Entry Properties
Last modified
11/6/2019 10:15:04 AM
Creation date
11/6/2019 9:43:22 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003986
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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EHD - Public
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117 CHAIN OF CUSTOD CORD <br /> .�.� r M MIMI M <br /> Cleological Audit Services, Inc. �- � <br /> Date. Page f of <br /> low <br /> client PROJPCT MAMA ER <br /> PHONE NUMBER <br /> rIX-11') 95Z G.z 6�i <br /> PROJECT NAME SAMPLERS IStg alu <br /> SA?APLc_Tv PE <br /> SAMPLE LOCATION DATE TIME WA;ER AIR SOLID NO.OF TESTS <br /> NUMBER DESCRIPTION I Comp. Gf30- CNTNRS REQUIRED <br /> Wei f (D /-0/f •d - x -3 7'illf7� �T <br /> E <br /> Af t►-S_&-A; ���� G���// - � Q2, t-, X <br /> I <br /> UW-5-71 q At,., O&e *s g -e7�as Y- <br /> I f <br /> 1 <br /> Reh t5n Trot!} / Recerved by:{Stgnawre c Date/Time <br /> i <br /> Cp C t <br /> Relinquished by:(Signature) Received by:(Signature) <br /> Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory lot fleid analys+s DatelTime <br /> (Signature) 7� <br /> Dispatched by:(SignatLre) Date/Time Received for Laboratory by: Date+lTime <br /> Method of 5hipnlenl: I'sereby authorize the performance of the above in' tCate'd work. <br /> Special Instructions: <br /> I <br /> SOURCE Adaated born U.:S.EPA.igff; <br /> CCIh1fb <br />
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