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ARCHIVED REPORTS XR0000745
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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B
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BEVERLY
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104
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2900 - Site Mitigation Program
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PR0540667
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ARCHIVED REPORTS XR0000745
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Entry Properties
Last modified
2/8/2019 10:05:26 AM
Creation date
2/8/2019 8:42:08 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000745
RECORD_ID
PR0540667
PE
2960
FACILITY_ID
FA0023252
FACILITY_NAME
WELDON CHURCH PROPERTY
STREET_NUMBER
104
Direction
W
STREET_NAME
BEVERLY
STREET_TYPE
PL
City
TRACY
Zip
95376
CURRENT_STATUS
01
SITE_LOCATION
104 W BEVERLY PL
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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Advanced CHAIN OF CUSTODY RECORD: <br /> ;. GeoEnvironmental, Inc. Date Page / of <br /> of Northern California <br /> 1803 West March Lane,Suite A-Stockton,California-95207-(209)9560264-Fax(209)956-0700 47 <br /> Client Project Manager Tests Required <br /> Phone Number <br /> 4-8 CtK1 <br /> Samplers: (Signature) Invoice: <br /> Project Name AGE AD <br /> Client <br /> Sample Location Sample Type No. of �' / <br /> Number Description Date Time Water Solid A Notes <br /> p comp. drab. AirJZ <br /> CDniS. h_ r at,�., •a� <br /> 15, <br /> Relinquished y: (Signature Yiv�ed <br /> y: rgn e t ��Q_p/ Date/Time <br /> r <br /> Relinquished by: (Signature) by:.(Sig ature) Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for lield analysis; (Signature) Date/Time <br /> Dispatched by. (Signature) Date/Time Received for Laboratory by: Date/Time <br /> Method of Shipment: de� <br /> LabR.,-, <br /> tory me <br /> cel_Vel � �Q Ae v <br /> Special Instructions: NJ <br /> 1 hereby authorizel the performance of the above Indicated worts. <br /> ICF_JT <br /> E,`0 SPACEtIT <br />
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