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ARCHIVED REPORTS XR0003991
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 XR0003991
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Entry Properties
Last modified
11/6/2019 10:09:14 AM
Creation date
11/6/2019 9:45:16 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003991
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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S Advanced • CHAIN OF CUSTODOECORD <br /> GeoEnvironmental, Inc. Date 2.2 -q 7 Page 1 of� <br /> =" of Northern Calrfa nta <br /> 1803 West March Lane, Suite A Stockton, California 95207 (209)956-0264-Fax(209)956-0700 <br /> Client M 5 IN/ ProjectManager <br /> Tests Required <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> X"U-VV\ �i-��� ��` �� AGE <br /> Project Name Arl * A Yl 1515 �, <br /> Client ❑ <br /> h <br /> Sample Type <br /> Sample Location Date Time Water Solid No of r�`r Notes <br /> Number Description romp Grab Air Conts <br /> V Ll 7 X I - <br /> P4 9 -05- 1 }( - 3- <br /> ps -zo <br /> F` 5 - )Lo <br /> 5- <br /> Relinquished by (Signature) ecerved y ( ignature) DatetTtme <br /> 711 Eco <br /> Relinquished by (Signature) Recery (Signa ure) DatelTrme <br /> �--- /n Q d <br /> Relinquished by (Signature) Recewe y obile Labor tory for field analysis (Signature) /` DatelTime <br /> Dispatched by (Signature) Date/Time Received for Laboratory by DatelTrme <br /> Method of Shipment Laboratory Name <br /> Special Instructions rr I hereby authonze the performance of the above indicated work <br /> of <br />
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