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EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0517512
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Last modified
11/1/2018 6:59:48 PM
Creation date
11/1/2018 3:14:09 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0517512
PE
2960
FACILITY_ID
FA0013476
FACILITY_NAME
FTG CONSTRUCTION MATERIALS, INC
STREET_NUMBER
925
Direction
W
STREET_NAME
ANDERSON
STREET_TYPE
ST
City
STOCKTON
Zip
95202
CURRENT_STATUS
01
SITE_LOCATION
925 W ANDERSON ST
P_LOCATION
01
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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{ Advanced CHAIN OF CUSTODY RECORD i� <br /> Dade Page2 of�. m <br /> GeoEnvironmental, Inc, N <br /> m <br /> 837 Shaw Road-Stockton,California-95215-(209) 487-1006 - Fax (209)407-1118 � <br /> Client a Project Manager Tests Required <br /> Phone Number `, m <br /> t u Irwoice: <br /> Samplers: (Signatu ) <br /> en AGE EJz <br /> Project Name G ��' (/` Client ❑ <br /> � � hr • � <br /> Sample Location Sample Type No <br /> Date Time Wider Solid . of Notes <br /> Number Description Camp. Grab. Air Corms. <br /> D- 15 927 /y'/6 <br /> S, zd �/ I �° m <br /> in <br /> ?J-3 - /� 9 G7 �j X5"'23 ✓ I <br /> 15'27 1 Z <br /> 0 Rims <br /> eli ra y rgnature). eoe a y: rgnature B- ��0� 'Voi <br /> R h quashed It ignalure). Recel.ed by: (Signature) <br /> O etarTime <br /> Relinquished by: (Signature) Received by Mobile Laboratory rot field analysis: (Signator.) <br /> Dispatched by: (Signature) <br /> Oaterrime Received loz Labotatory by: Uaterrims <br /> Laboratory Name <br /> Malhed of Shipment: /ec/� D <br /> R <br /> I hereby, a raze th , erlerrora of the .boor dieeted work. <br /> Special Insfructiona: <br />
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