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2900 - Site Mitigation Program
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PR0517323
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
2/14/2019 3:46:08 PM
Creation date
2/14/2019 9:40:06 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0517323
PE
2960
FACILITY_ID
FA0013339
FACILITY_NAME
MT HOUSE SITES 1-6
STREET_NUMBER
0
STREET_NAME
BYRON
STREET_TYPE
RD
City
TRACY
Zip
95376
CURRENT_STATUS
01
SITE_LOCATION
BYRON RD
P_DISTRICT
005
QC Status
Approved
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WNg
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EHD - Public
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EMU <br /> "`,t 5xT-..Pa., X=y7 ' <br /> ContiF artl -T�cnloie , Inc <br /> CHAIN–OF–CUSTODY ❑ -21663 Brian Lane ❑ 1125 North Goldem State Boulevard ❑ 188 Frank West Circle, Suite I <br /> P.O, Box 3905 Suite G Stockton, CA 95206 <br /> Sonora, California 95370 Turlock,CA 95381 209-234-0518 ; <br /> 209-532-0361 209-668=9256 209-2340538 (fax) <br /> 209-532-0773 (fax) 209-668=9257 (fax) condor@condorstdckton.com (e-ma <br /> SHIPPED 'TO: `y-r ':3,�., SEND RESULTS TO: <br /> NAME: <br /> + A t. A OFFICE: <br /> ❑ PLEASE FAX RESULTS: PROJECT: <br /> PROJECT NO. <br /> NO. ����. ✓ Verification <br /> SAMPLED BY: of �y <br /> {' _... <br /> con- <br /> (Signature) tain- Q` <br /> Date Tirne Sample ID ers REMARKS : MI8C. <br /> ir- <br /> Relinquished ` y , <br /> Date: Time: Received >3 Date Time: <br /> (Sign.,(Signature) v/ <br /> �•-.1 _ i> t;; ure) f <br /> '�� <br /> Relinquished B i- ' Dat f� Time: Received Bye' % D� 7a e' Time: <br /> (Signature) �'"/" /i 1(7,1 P/` (Signature) � <br /> Relinquished ry: Date: Time: Received By: ate: Time: <br /> (Signature) (Signature) <br />
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