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ARCHIVED REPORTS_XR0004136
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_XR0004136
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Entry Properties
Last modified
2/12/2020 4:18:17 PM
Creation date
2/12/2020 9:09:30 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004136
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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CHAIN OF CUSTOD%ECORD <br /> Advanced <br /> Date )--! s Page of <br /> GeoEnvironmental, Inc. <br /> 837 Shaw Road-Stockton,California-95215- (209) 467-1006- Fax(209)467-1118 <br /> Client .� Project Manager Tests Required <br /> L <br /> Phone Number <br /> r <br /> Samplers (Signature) Invoice <br /> AGE [D <br /> Project NafneChem F <br /> V <br /> I Vi <br /> Sample Type <br /> Sample Location Date Time Water Solid No of !w �' Notes <br /> Number Description Air Co <br /> Comp crab f�ts <br /> r <br /> re inquis e I �t ygnature verve y rgnature e� A t , Onte/Time <br /> I /_3 E 1 f <br /> Relinquished by I ignaturey Received by (Signature) Datelr;me <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) QatelTrme <br /> Dispatched by (Signature} DatefUrne ceived for ratory Date}Trme <br /> Method of Shipment Laboratory Name <br /> Specrai InStfucdons I hereby authorize the pe formance of the above indicated work <br /> //1 <br />
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