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ARCHIVED REPORTS XR0001600
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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C
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CLAY
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639
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3500 - Local Oversight Program
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PR0544513
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ARCHIVED REPORTS XR0001600
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Entry Properties
Last modified
6/14/2019 1:20:12 PM
Creation date
6/14/2019 10:35:17 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0001600
RECORD_ID
PR0544513
PE
3528
FACILITY_ID
FA0024115
FACILITY_NAME
WEST CLAY PROPERTY
STREET_NUMBER
639
Direction
W
STREET_NAME
CLAY
STREET_TYPE
ST
City
STOCKTON
Zip
95209
APN
14707110
CURRENT_STATUS
02
SITE_LOCATION
639 W CLAY ST
P_LOCATION
01
QC Status
Approved
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EHD - Public
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� Advanced -_ <br /> CHAIN OF CUSTOORECORD <br /> GeoEnvironmental, Inc. Date /0001 Page of <br /> 4005 North Wilson Way-Stockton,Calillomia-95205-(209)467-1006-Fax(209)467-1118 � i 14S- <br /> Client <br /> [— <br /> Client Project Manager l iJ Tests Required <br /> etlln) mc-ki 6beAl-I <br /> —4 P <br /> hu ber <br /> X0400( <br /> Samplers (Signature) Invoice <br /> V-t-"/'Wi + �7, AGE O <br /> Project Name k)e$-F 01,41 Pr'0PWt1'e5 0d b Client ❑� o� <br /> Sample Type <br /> Sample Location No of <br /> Comp Grab <br /> Number Description Date Time Water Air Solid Conts �a 4r}� 23268 <br /> /)Ap�} � <br /> r r l -/-f 08-w <br /> J 23269 <br /> t <br /> 6 Rog��4 23270 <br /> 20' i <br /> F <br /> l i <br /> q -Z5 08.f7 23271 <br /> 01:0¢ ' <br /> 23272 <br /> 23273 1 � <br /> 5/0 _Z0' !3: 23274 <br /> Date/]ime <br /> e inquis e y ignatureRacere n'v� � 5- n .•5477 &D <br /> ehnquished by (Signature) Nieed by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> 246 <br /> Dispatched by (Signature) Dale/Time Received for Laboratory by Oate/Tlme <br /> Method at Shipment O1r Laboratory Name ! ���� L#Y <br /> L�NSG v <br /> Special Instructions i I hereby authorize the peri mance of the above indicated work <br /> �CEft� PRESERVATION <br /> GOODCONDPION RIAS � <br />
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