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REMOVAL_2002
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0231341
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REMOVAL_2002
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Entry Properties
Last modified
9/15/2021 1:20:11 PM
Creation date
11/8/2018 10:23:08 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
REMOVAL
FileName_PostFix
2002
RECORD_ID
PR0231341
PE
2361
FACILITY_ID
FA0003629
FACILITY_NAME
ARCO STATION #434*
STREET_NUMBER
501
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
03119028
CURRENT_STATUS
02
SITE_LOCATION
501 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Supplemental fields
FilePath
\MIGRATIONS3\K\KETTLEMAN\501\PR0231341\REMOVAL 2002.PDF
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EHD - Public
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SIEQTTOIA,ANALYMAL SAAME FXCEV 1r Lac <br /> [I. <br /> DA EReWVedatLab: l -�-OZC.BY(PRTM) Arink ng lrnter for <br /> LS Tieceived at Lab: el� regulatory pvxpOscs: YES A'ORKOROER: tij LTAG LN T7ATE: /b c-c7 L Wastmmter for <br /> RCLE regulatory purposes: YU NO <br /> �APPROPRTATER�SpO�I > T1ATiCOtNTAINER SAI2LF DATE <br /> # # CT MMT ID DESOUPTION MATRLY SAINaLED DOIN (stod Se s CONDTTTON .TC.I <br /> Y ) Presentent roain-0f-Custod Pres /Abs, 1r* -3 tb Y3r� <br /> i1 3. Tr. Sc Repots or -p$�Li <br /> 31 Pwld List: Present/ bsen <br /> 4.ALblll: Aisbill l Sot &t <br /> Present/ eat �- <br /> S.Airbill fA: <br /> 6. Samn]c Labels: res Absent 7 ��•3 �(z ' <br /> 7. SamplC lDs: L Not Listed !G <br /> oa'QlaiaroF•Custod <br /> A. Sample Condition: Broken*/ s` <br /> 4. Does infotmsrion on <br /> s custody reports,tra#ic <br /> reports and sample <br /> labels s e7 Y INo*. <br /> . Sample reccived v4thin <br /> A hold tfinc: Y I No* <br /> 11. Properpresen ativC <br /> used; <br /> 12. Temp Rec.at Lab: <br /> p (Acceptance range for sample$ //----� <br /> .quiring thermal pres.;4+I-2°C) 1'�C No** <br /> c tion if lam" . <br /> *If Circled' contact Pro'cct Manner and attach record o£rosolution. <br /> sample Raceipr Log <br /> kion 2.2(014/11102) <br /> laces•dve 411, On 2.1(?1110/00) <br /> 0471&02 <br />
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