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ARCHIVED REPORTS_XR0012432
Environmental Health - Public
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EHD Program Facility Records by Street Name
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L
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LODI
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501
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2900 - Site Mitigation Program
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PR0505714
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ARCHIVED REPORTS_XR0012432
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Entry Properties
Last modified
3/4/2020 11:45:32 AM
Creation date
3/4/2020 9:15:44 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012432
RECORD_ID
PR0505714
PE
2950
FACILITY_ID
FA0003590
FACILITY_NAME
M B P
STREET_NUMBER
501
Direction
W
STREET_NAME
LODI
STREET_TYPE
AVE
City
LODI
Zip
95240
APN
03731045
CURRENT_STATUS
02
SITE_LOCATION
501 W LODI AVE
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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r� r� it rr r rr rr rr �r rr ■r rr r r r■� r rr� <br /> Advanced CHAIN OF CUSTC& RECORD <br /> --_ - GeoEnvironmental, Inc, Date Page / of <br /> 4005 North Wilson Way-Stockton,California-95205 (209)467-1006-Fax(209)467-1118 t j l l 7,A y <br /> ClientProject Manager r t <br /> Tests Required <br /> Phone Number 4 <br /> ft V-e '-; <br /> Samplers (Signature) Invoice <br /> Project NameI 10I — <br /> Client AGE <br /> �n j � – � 5 �� � ` i 1 ❑ <br /> Sample 1-y pe Sample Location No of <br /> Number Description Date Time Water Air Solid Conts <br /> Com Grab <br /> p 10959 <br /> 10960 <br /> Z' <br /> op 10961 <br /> 10962 ; <br /> e inquis y ignatufe R <br /> eceivey Signature) DatelTime <br /> s--��-f a� rJ <br /> Relinq ished by•(Signa r y (Signature) DalelTime <br /> 2.- <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date(Time <br /> Dispatched by (Signature) Oate/Time Received for Laboratory by Date/Time <br /> Method of Shipment - LaboOM <br /> r - <br /> Special Instructions VOAS 0&G METALS OTHER I hereby authorize the performance of the above Indicated work <br /> GOOD CONDITIONZ APPROPRIATE if <br /> HEAD SPACE ABSENT CONTAINERS <br />
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