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ARCHIVED REPORTS_XR0012436
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_XR0012436
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Entry Properties
Last modified
3/4/2020 12:31:26 PM
Creation date
3/4/2020 9:17:20 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012436
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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I <br /> ( Advanced CHAIN OF CUSTOD PECORD <br /> -11f <br /> 5 <br /> GeciEnvironmental, Inc. Date Page Of <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467 1006-Fax(209)467-1118 101 X RG 3 <br /> Client { t ro)ect Mana er Tests Required <br /> Phone Number <br /> Samplers (Signature) �/ Invoice <br /> Project Name r AGE ] <br /> Client EJ <br /> � <br /> Sample Location Date Time Sample Type Water Solid No of , <br /> Number Description Comp Grab Air Conts 98062 <br /> BYui-�—n 98063 <br /> � —' 3�� f ✓ 98064 <br /> VA V3-6- 98065 <br /> 53,5— 16- 10-�O'q 13D ✓ 98066 <br /> S 5-2-5; 75 98067 <br /> �JD f ✓ 98060 <br /> e rn S e y ( rgnalure) ec e y rgnature DatefTlma <br /> Relinquished by (5rgnature) R ived by (Signal a) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for held analysis (Signature) DatefTrme <br /> Dispatched by (Signature) Date/Time Received for Laboratory by DalefTime <br /> Method of Shipment Laboratory N�� <br /> Special Instructions i I herebby authorize the performance of the above indicated work <br /> 9 _ VOAS O&G MET��S OTHER ` AA <br /> GOOD CONDITON-4 APPROPRIATEMAMMAS <br /> t -__X. COWAINERS <br />
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