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ARCHIVED REPORTS XR0008992
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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V
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VICTOR
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880
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2900 - Site Mitigation Program
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PR0503634
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ARCHIVED REPORTS XR0008992
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Entry Properties
Last modified
5/7/2019 5:06:03 PM
Creation date
5/7/2019 4:29:52 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008992
RECORD_ID
PR0503634
PE
2950
FACILITY_ID
FA0005914
FACILITY_NAME
VICTOR ROAD SHELL
STREET_NUMBER
880
STREET_NAME
VICTOR
STREET_TYPE
RD
City
LODI
Zip
95240
APN
04905032
CURRENT_STATUS
02
SITE_LOCATION
880 VICTOR RD
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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4r <br /> SHELL OIL COMPANY CHAIN OF CUSTODY RECO D Date /d2 p2o2 —9y <br /> RETAIL ENVIRONMENTAL ENGINEERING - WEST Serial No ��b'� Page / of <br /> Site Address Analysis Required SAB lU <br /> G q L 1 1 v�rl CHECK ONE(1 t 407(ONLY C11DT TURN AROUNp 71YE <br /> Shell Engineer + V 0W Monkoring ❑ uet <br /> J9 Phane No .�sro� 24 Hour: ❑ <br /> ��, �,� �— �ax -.�A�- 51s Invesllpnllan 1441 <br /> Consultant Name & Address u�2� C�yg�-� ��, N <br /> Sol ClassllyrOlspossl 4442 4B l+ous El <br /> 0 Walor l5 days ❑ INormWq <br /> SV r i 1121 l v o �& A) u um-(5 C� - co classllyl)lsposal El 4443 <br /> Hsu tans Contact Phone No OtherSovild , <br /> �1 v f c 1 Se �'1 Fax z z �c cue) <br /> m g O 6 Mr Rem or Sys Ll ".52 <br /> °d NOTE Nolly Lab as <br /> Comments � � � � 0 N Q� rV Water Rem or Sys soon as possible of <br /> t7 C3 W ❑ 4455 24148 Iwo TAT� - OAM ❑ <br /> Sampled by / 2 Ln in N x � Other <br /> w °D b UST AGENCY <br /> a s CL L U to m <br /> Printed Name M 0. w O n u m a <br /> UJ w `" @ o G8. MATERIAL SAMPLE <br /> Sample ID pate Sludge Soll Water Ali, NO °I r^ E c j EE DESCRIPTION CONDITION/ <br /> conts m � cv <br /> COMMENTS <br /> V1 2-A <br /> SSP !i �14k <br /> �� -- - — -- --- — -- — — Ol1 i2f <br /> , _ <br /> s 0"ture <br /> Printed a 7 Dale _ R-0c (sl re) �� Pd ems pals <br /> (vf `� _ Time Z�,S <br /> eRnq Prinl amsTime <br /> Data tsiq rel Pr Hied NName Data <br /> Time _- L� .�Ly�r�:{tin�� Time b <br /> fl a P nfed Name Dale calved(signalurel Prinled Name Dale <br /> Time <br /> Tame <br /> - THE tA80FiATORY MUST PI7(7V1UE A COf'YOF THIS CHAIN cN COSIODY WITII INVGIC.t_ ANO r1EStfl TS --- <br /> n ulro7 - ---- -- - --- — <br />
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