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SU0004938 SSNL
EnvironmentalHealth
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PA-0500028
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SU0004938 SSNL
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Entry Properties
Last modified
5/7/2020 11:31:20 AM
Creation date
9/4/2019 6:30:51 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SU0004938
PE
2622
FACILITY_NAME
PA-0500028
STREET_NUMBER
27475
Direction
S
STREET_NAME
FAIROAKS
STREET_TYPE
RD
City
TRACY
APN
24811033
ENTERED_DATE
3/23/2005 12:00:00 AM
SITE_LOCATION
27475 S FAIROAKS RD
RECEIVED_DATE
3/23/2005 12:00:00 AM
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\F\FAIROAKS\27475\PA-0500028\SU0004938\NL STDY.PDF
Tags
EHD - Public
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I <br /> A & L 1IESTER:N LABORATORIES9 INC. <br /> 1311 Woodland Ave..#1.• Modesto <br /> , California 95351 • Phone 209-529-4CBC <br /> I <br /> CHAIN OF CUSTODY <br /> Client <br /> Q <br /> Address Phone <br /> �} CC to: <br /> Zip <br /> Signature of person authorizing work <br /> under terms stated below- <br /> Net 30 days. All accounts past due will be subject to interest charge of 1.5% per month. <br /> `Fazardous materials are the properly of the client. The client is res onsible for proper disposal of hazardous wastes. Clients not <br /> picking up hazardous wastes may be assessed an appropriate fee. <br /> I PROJECT If� /� No ANALYSES <br /> �✓ /``F/� f y/ of <br /> SAM ED BY: nature): Con. <br /> . lain• <br /> O&APe rs <br /> REMARKS <br /> sample' <br /> Il type Sample Location Date Time <br /> cr,o come. <br /> 18-© D <br /> Relin d by re): le Time. chive j by(signature); pale Time <br /> Relinqui hedbYis�gn lure): Dpte Time R elved`b ,(s� nature.:. <br /> rt Y g } Date Time <br /> Relnqurrheif�Y{�jg�jaty ) Date: Time F�acelvedbytslgnaiifre) <br /> Date Time <br /> i Relinqu15het� yjstgs atur j' 1' D t�: Tii>je Re ei�ed by (signature}. <br /> :r a Date Time <br /> Rellitquishtl by IstgnattaYB}� Date 'fiarnff cpved by. signatareJ <br /> Date Time <br /> t <br /> Site"Tirhu� <br /> C}rfym g�f�1rie <br /> pJ�'clfk' Tpf' t11SI' <br /> Finish.:. TbW'Hours: <br /> L�edacated"Ex cl[isfvely to Provrdfng;QUiZI ty Analytrc l-Services <br />
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