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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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LOCKEFORD
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1301
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2900 - Site Mitigation Program
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PR0518316
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COMPLIANCE INFO
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Entry Properties
Last modified
2/28/2020 3:53:20 PM
Creation date
2/28/2020 10:26:10 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0518316
PE
2950
FACILITY_ID
FA0013830
FACILITY_NAME
KIKUCHI/KITASOE PROPERTY
STREET_NUMBER
1301
Direction
W
STREET_NAME
LOCKEFORD
STREET_TYPE
ST
City
LODI
Zip
95242
APN
03533015
CURRENT_STATUS
02
SITE_LOCATION
1301 W LOCKEFORD ST
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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Advanced CI IAIN OF CUSTODY REConr)- <br /> 6 VA'/0-L 3 <br /> GeoEnvironmental, Inc. Date- Page of— - <br /> . ...... 837 Shaw Road-Stockton, California- 95215 - (209) 467-1006 - Fax (209)467-1118 <br /> 0"1-019 <br /> Client Project Man Tests Required <br /> (-Al-k'y rJ Phone Number <br /> Samplers: (Signature) invoice: <br /> Project NameAGE <br /> V,GLA-tlk- Client <br /> Sample Location Sample Type No. f <br /> Number Description Date Time W er Solid o Notes <br /> Comp. Web. Air Conts. <br /> J 4 111> <br /> C'q ot-r4 <br /> T 1 X <br /> R h i na re) (Signature) Date ime <br /> Relln4ulsh <br /> ed by: Received by: (Signature) <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analyads: (SlIpaw(a) Datojisna <br /> A <br /> Dispatched by; (Signature) Date/Tima Recolvad-for-Laboratory by: Dale irna <br /> Method of Shipment: Labory 'Nat <br /> Pa <br /> Special Instructions: I hereby authorize thea <br /> RIO Iniptice of the above indicated work. <br />
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