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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
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SJGOV\sballwahn
Tags
EHD - Public
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� 1, � � � � � � � � r � 1• � � i, lis *w� <br /> UST <br /> Advanced CHAINO ODY ECO D <br /> GeoEnvironmental, Inc. Date!1 Pape at <br /> 4005 North Wilson way-Stockton,Calitomia-95205-(209)467-1006-Fax(209)467-1118 <br /> Client Project Manager Tests Required <br /> —7Zj4l*�LA <br /> Phone Number <br /> 7 - 000 <br /> Samplers (Signature) Invoice- <br /> ► <br /> � <br /> Project Name / � AGE V G Client ❑ <br /> ! � l <br /> Sample Type ` <br /> Sample Location No of <br /> p Date Time Water Solid Notes <br /> Number Description Comp Crab Ar Conts ! <br /> ryf ' <br /> (AO- 11 Iva <br /> Z� you - <br /> 251 <br /> it _25167 r <br /> { - Zc� Z•p 7 - µL <br /> - 30 <br /> 1 25.159 <br /> tV12, d 26170 <br /> 4101 2517. 1 <br /> f <br /> V ]Z 135 I 25172 , <br /> qu s a �inlatura ece ve y gnature <br /> re Received b (Signature) DatetTime <br /> Rahn sshed by (Signature) y <br /> Reiinquishe by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) DaletTlme vedJorLaboratory by LV t]atarTlms <br /> Method of Shipment CA LLaborittory Nalln eye k i <br /> fl ti( �t� Y <br /> Special lnstcucttons 1,41ktehy authorize th per} rmence of the above indicated work <br /> p I r M T-15C dl M O r �( AS 0&G;M�fAL'S OTNk� 4 <br /> o c l r cam}— v . 10E(� - IAMnrJ,f 1.-rfJ <br /> -� <br /> fiUr Rinii <br /> UEAn CDAN7 ADC'U1'f nn►,rkwr-,n <br />
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