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ARCHIVED REPORTS_XR0004206
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_XR0004206
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Entry Properties
Last modified
2/12/2020 3:28:34 PM
Creation date
2/12/2020 9:15:13 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004206
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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� Advanced <br /> CHAIN OF CUSTODOECORt7 <br /> GeoEnvironmental, Inc. Date �' Pie of <br /> 837 Shaw Road - Stockton California-95215-(209)467 1006- Fax(209)467-1118 _ !0 <br /> Client I. Profect�g� ] Tests Required <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> Project Name /6mF- M IV; AW1, � � � / Ci ent ❑' <br /> f <br /> Sample Location Solid No of f� / Notes <br /> Number Description Date Time Sample Type Water Air Conts / <br /> Comp Grab <br /> t( F <br /> � - It &T- <br /> �� <br /> ATI�I <br /> le <br /> 35 <br /> Fin is e y { nature ece,ve y ,gnatura Daterrim <br /> ee <br /> Rel,nqu,shed by (Signature) Received by (Signature) <br /> aternme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Daterf ime Received for Laboratory b YY On�te/Timee <br /> Method of ShipmentLab tory Name <br /> k+ - <br /> Special Instructions I hereby authorize the performance of the above indicated work <br /> t <br />
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