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ARCHIVED REPORTS_XR0007285
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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WILSON
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2211
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3500 - Local Oversight Program
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PR0545106
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ARCHIVED REPORTS_XR0007285
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Last modified
12/19/2019 4:21:13 PM
Creation date
12/19/2019 4:03:33 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007285
RECORD_ID
PR0545106
PE
3529
FACILITY_ID
FA0003694
FACILITY_NAME
RIVER CITY PETROLEUM CARDLOCK
STREET_NUMBER
2211
Direction
N
STREET_NAME
WILSON
STREET_TYPE
WAY
City
STOCKTON
Zip
95205
APN
11707050
CURRENT_STATUS
02
SITE_LOCATION
2211 N WILSON WAY
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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SJGOV\wng
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EHD - Public
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OHAIN OF CUSTODY RECORD B�IITo <br /> P01Box g3 der AvenueSherwood <br /> Hilmar, California 95324 <br /> Labs (209) 667-5258 Attention Phone <br /> C O R P O R A T 1 0 N FAX (209) 667-2581 Page of <br /> Joh Number PO # Project Name <br /> Samplers (Signature) Site Address <br /> SAMPLE LOCATION DATE TIME NUMBER TYPE SAMPLE <br /> (IDENTIFICATION) (MTH/DAYNR) (HOURIMIN) OF (GRAB OR <br /> CONTAtNERS COMPOSITE) MATRIX `� Z` Q <br /> �Q �� REMARKS <br /> I I <br /> I <br /> ReImpshed By (Signature) Date/Ttme Received By (Signature) Date/Time TURNAROUND TIME <br /> Relinquished By (Signature) Date/Time Received By (Signature) Date/Time 24 HOUR ❑ <br /> 48 HOUR ❑ <br /> Relinquished By (Signature) Date/Time Received By (Signature) Datef ime 5 DAY ❑ <br /> DISTRIBUTION Original Accompanies Shipment Canary Copy Sherwood Pink Copy Sampler NOTE Samptes are discarded 30 days after results are reported unless other arrangements are made <br />
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