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COMPLIANCE INFO_1986-2006
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0231331
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COMPLIANCE INFO_1986-2006
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Last modified
6/20/2023 9:32:19 AM
Creation date
6/3/2020 9:43:38 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1986-2006
RECORD_ID
PR0231331
PE
2351
FACILITY_ID
FA0000513
FACILITY_NAME
LODI MEMORIAL HOSPITAL
STREET_NUMBER
975
Direction
S
STREET_NAME
FAIRMONT
STREET_TYPE
AVE
City
LODI
Zip
95240
APN
03107039
CURRENT_STATUS
01
SITE_LOCATION
975 S FAIRMONT AVE
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2351_PR0231331_975 S FAIRMONT_1986-2006.tif
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EHD - Public
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CASTLE ANALYTICAL LABORATORY CHAIN OF CUSTODY <br />Location: 2333 Shuttle Drive, Bldg 908!909, Atwater, CA 95301 Certificate No. 2480 <br />Mailing Address: 2333 Shuttle Drive, Atwater, CA 95307 PAGE OF <br />Phone: (209) 3$4-2930 - Fax: (209) 3134-1507 <br />�'; � r <br />Address: e" <br />Address: <br />CitylStateIZIP: r <br />Phone I FAX: r <br />Prof # I P_O. # --® CJ <br />Report Attention: <br />Sampler Signature: <br />tail ID# SAMPLE ID DATE <br />t, <br />4 <br />, <br />TIME DESCRIPTION/LOCATION <br />_ <br />_m ° <br />�° <br />W g <br />a s <br />,—�a, <br />W g <br />a- <br />x o <br />Q ° <br />� <br />a g <br />.1_ <br />REQUESTED . <br />ANALYSES <br />03 <br />W <br />z <br />O <br />LL <br />Uj <br />Method of Shipment: <br />,votes �-t''tQ )15gx <br />_ <br />p� 33 <br />j 7.'-3Y <br />, r <br />ge t I� <br />ONS/REMARKS <br />o <br />�, a °� <br />a LLJW m <br />O W � a <br />a w a a m ®Zo <br />= m om m <br />W <br />-�s �c-a <br />s' <br />i:Io <br />� <br />-f <br />✓ <br />'6 J1 <br />_ ® omr numom or concamers submMW to <br />Hata ie RdnteelNal�e . - Date ini� Cern :an Norrie: the laboratory <br />Relinquished by: _ �{�j®d,f y -m a g; (-e Note: All special requests (e.g. <br />ec,&ed by-vt quick turn times) must be cleared <br />ePincuish <br />7. <br />through authorized laboratory <br />personnel. <br />RESULTS DUE: <br />Ck VERBAL C3 WRFTTEN <br />A <br />D <br />X <br />Z <br />O <br />ro <br />G <br />W <br />W <br />00 <br />A <br />N <br />(A <br />M <br />0 <br />3 <br />0i <br />Lt <br />r-� <br />W <br />0 <br />W <br />3 <br />-0 <br />.A <br />
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