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ARCHIVED REPORTS XR0000264
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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B
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BANNER
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6437
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2900 - Site Mitigation Program
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PR0526345
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ARCHIVED REPORTS XR0000264
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Entry Properties
Last modified
2/5/2019 4:05:52 PM
Creation date
2/5/2019 3:53:00 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000264
RECORD_ID
PR0526345
PE
2957
FACILITY_ID
FA0017827
FACILITY_NAME
FLAG CITY SHELL
STREET_NUMBER
6437
Direction
W
STREET_NAME
BANNER
STREET_TYPE
ST
City
LODI
Zip
95242
APN
05532019
CURRENT_STATUS
01
SITE_LOCATION
6437 W BANNER ST
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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11 AnalyticalSciences CHAIN OF CUSTODY <br /> P O Box 750336 Petaluma CA 94975-0336 ' <br /> /1/VI 110 Liberty Street,Petaluma CA 94952 D' <br /> S (707)769-3128 Lab Project Number o <br /> Fax(707)769.8093 Client's Protect Name New es <br /> Client's Protect Number NWP01 004 <br /> CLIENT"INFORMATION <br /> Company Name ex Envlrotech,Inc GeoTracker EDF X Yes No <br /> Address 11244 Pyntes Wy Global ID T0607736979 <br /> Gold River,CA 95670 n F7UJtM.AR01 tfd TIME(checkEorie�_ <br /> Contact Jennifer Worsley Same Day <br /> Phone# 916-851-0174 48 Hours 24 Hours <br /> Fax# 916-851-0177 5 Days X Normal Page 1 of 1 <br /> e-mail tenniferOaDexenvirotech com <br /> "k A` NALYSIS s ` ' " <br /> e� <br /> J <br /> R <br /> Date # Presv N rn <br /> Lab <br /> Item Client Sample ID ALT ID Sampled Time Matrix Cont. Y/N cj a�` Comments Sample# <br /> V � <br /> I LU <br /> a � <br /> H m <br /> i CSA-31-1 —.CSA-31-1 -93�r water 3 y X X (402/29a r <br /> 2 CSA-31-2 CSA-31-2 water 3 y X X C3 Y <br /> 3 <br /> 4 <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 <br /> ILL <br /> � €$IGNATURES <br /> hed ey <br /> Sampled By � 6e$ <br /> r <br /> 3,gn <br /> fie By <br /> 9O6 t�Date Time Signature D Time <br />
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