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FIELD DOCUMENTS
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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C
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2900 - Site Mitigation Program
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PR0503658
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Last modified
2/22/2019 4:50:24 PM
Creation date
2/22/2019 2:20:48 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0503658
PE
2950
FACILITY_ID
FA0005929
FACILITY_NAME
FIORE, FRANK
STREET_NUMBER
129
Direction
E
STREET_NAME
CENTER
STREET_TYPE
ST
City
MANTECA
Zip
95336
APN
22309120
CURRENT_STATUS
02
SITE_LOCATION
129 E CENTER ST
P_LOCATION
04
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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MOGWHF Environmental Consu]tants, lnc. <br /> Post Office Box 6729 <br /> CHAIN OF CUSTODY RECORD Modesto, CA 95355-6729 <br /> PROJECT NAME; <br /> ,,'' (209) 579-8138 - <br /> 1�� <br /> y 4 VS ature) e <br /> Number <br /> of `a' REMARKS <br /> on <br /> Number sme E A Station Location Con- <br /> c� tainers <br /> t✓ 7 <br /> Z-a J� X <br /> Lz- <br /> ` 7 - l <br /> Relinquished by(signature): Date / Time Received by (signature): Relinquished by(signature):pDate / Received by (sSgnaWre):Company or Agency: Company or Agency: Company or Agency: Company or Agency: <br /> Relinquished by(signature): Date / Time Received by (signature): Relinquished by: Date / Tice Received by (signature): <br /> Company or Agency: Company or Agency: Company or Agency: Company or Agency: <br /> sh d signature): Date / Time Received for Laboratory by: Date / Time Remarks/Shippi Information <br /> C n enc (signature) S •�a ,i,Q �� <br />
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