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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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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
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SJGOV\sballwahn
Tags
EHD - Public
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CHAIN OF CUSTOAECORD <br /> Advanced Date la(T Page :?= o <br /> GeciEnvironmental, Inc. <br /> 837 Shaw Road-Stockton, California-95215-(209)467-1006 - Fax (209)467-1118 <br /> P► Manager Tests Required <br /> Client c `� G `� Lviii, C���v- <br /> 7hone m -t(b& <br /> piers {Sig ur Invoice <br /> AGE ❑ <br /> Project Name e-" Gierit El <br /> Sample Type <br /> Sample Location Date Time Water Solid No.of Notes <br /> Number Description Comp GfaH Air C.onts <br /> Ul(r 031 <br /> I L <br /> eceive y 19nature Dateff <br /> Z-Z-2cl t tJ <br /> Date/Tune <br /> Relinquished by (Signature) Received by (Signature) <br /> Relinqugnature) Received by Mobile Laboratory for field analysis (Signature) <br /> Date/Time <br /> t)ispatchod by (Signature) <br /> Daterrime Received or Laboratory by DatelTime <br /> Lab ay�a <br /> Method at ShipmentCAA <br /> Special Instructions �� ! � t her authorize t per rmanee of the above indicated work <br /> l.r � <br />
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