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ARCHIVED REPORTS XR0000689
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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C
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CAPITOL
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6421
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2900 - Site Mitigation Program
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PR0522496
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ARCHIVED REPORTS XR0000689
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Entry Properties
Last modified
2/15/2019 9:44:24 PM
Creation date
2/15/2019 4:07:51 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000689
RECORD_ID
PR0522496
PE
2957
FACILITY_ID
FA0015317
FACILITY_NAME
FLAG CITY CHEVRON
STREET_NUMBER
6421
STREET_NAME
CAPITOL
STREET_TYPE
AVE
City
LODI
Zip
95245
APN
05532024
CURRENT_STATUS
02
SITE_LOCATION
6421 CAPITOL AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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co <br /> t M <br /> (a Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmentat, 1110 DateDa Page �i of ry <br /> n <br /> 4005 North Wrfson Way Stockton California 05205-(209y 467 1006 Fox(209)457 1116 <br /> -r Cr <br /> Ghent Prosect Managir Y <br /> Tests Required <br /> �— n <br /> _ P noNumber w <br /> �6 -Irry `" <br /> .y BO �' <br /> Y <br /> rs K <br /> (Signature) Invoice , <br /> Prosect Name165A AGE <br /> -�r � 6 Client ❑ <br /> ~ <br /> Sample Location Sample Type No of � � t,p <br /> Number Description Date Time _Water Air Solid Cants r�°r Notes <br /> Comp Grab ! <br /> JAW o1 _41765 C" <br /> / 5 <br /> 11 ,r Vo 41766 <br /> r <br /> t7 w4aajgo 1j�'_ Lo X i 41767 <br /> ry <br /> Q+d1gLo _ •� ft 4t1 rr 3 3(9 41768 <br /> J /;, �� t <br /> A <br /> 1041769 <br /> 1 <br /> 41q0 x X IX <br /> 770 f <br /> t � <br /> 41771 ' o <br /> /(9 /0 <br /> � rO J r r C3 <br /> ern sFe in !�eceive y gna ureRehnqulshed by (Sature) Received by (Signature) Data/Time D <br /> islt�ha by�i (Signature) Rocelved by Mobile Laboratory for held analysis (Signature) Ontellime <br /> 4 ow <br /> Dvipalched by ISlgnature) pato/time Reoslved for Laboratory by <br /> p■t•J'Tlme <br /> Method of Shipment <br /> C <br /> Laboratory Nam m <br /> C r l D <br /> Special Inslruclivna , <br /> �'tn�^r ,�.-„rr�,7t,�� thereby uih Izs the r1 rmance of the ■bone Indicated work w <br /> �_ <br />
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