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ARCHIVED REPORTS_XR0004126
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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1301
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3500 - Local Oversight Program
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PR0545342
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ARCHIVED REPORTS_XR0004126
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Entry Properties
Last modified
2/12/2020 3:43:40 PM
Creation date
2/12/2020 9:05:46 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004126
RECORD_ID
PR0545342
PE
3528
FACILITY_ID
FA0000392
FACILITY_NAME
FLAMES LIQUOR
STREET_NUMBER
1301
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95242
APN
03104030
CURRENT_STATUS
02
SITE_LOCATION
1301 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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� 1♦.� � ll� � � I• � � � i � �■ tttttt� � ..� <br /> Advanced CHAIN OF CUSTODY RECORD <br /> Date Page -!L of <br /> GeciEnyironmental, Inc. <br /> 4005 North Wilson Way-Stockton,California 95205-(209)467-1006-Fax(2091467 1118 <br /> i <br /> Client EZ1166— Project Manag4�. 'bests Required <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> � A 't <br /> Project Name Citi t� <br /> Sample Type <br /> Sample Location Date Time WaterSolid / Notes <br /> Comp arab Air Cats ' <br /> Number Description <br /> q, 25169' <br /> 15fiD <br /> 2 8161f <br /> 2512 <br /> 26163 <br /> VJ -3_65 ! 10: o s 2 51 fi 4- <br /> V-J 4/01 1 LU <br /> l 251fi5 <br /> e s a y i a e eceiva by (Signature) — � unru�r moo` <br /> Relinqur d by (Signature) Raceived by (Signature) DatelTtme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DetelTime <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Date/time <br /> � @ Icw. <br /> Method of Shipment * Laboratory Name <br /> q ir 1�"OvAe&o Z4-5 <br /> Special Instructionsl hereby authorize arforrAnce of the above indicated work <br /> cant '�w� i fis IMPvaAs o&ls METAts P""- <br /> .�...,. PRESER4ATI0 <br /> o ~'V.v' u'— ofGOOD CONDITION I APPPA <br /> HFADSPAf F41 19-w M!TA'lKDQ <br />
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