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FIELD DOCUMENTS
EnvironmentalHealth
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2025
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2900 - Site Mitigation Program
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PR0505804
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Last modified
1/31/2020 6:06:16 PM
Creation date
1/31/2020 3:51:33 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0505804
PE
2960
FACILITY_ID
FA0007013
FACILITY_NAME
KOPPEL STOCKTON TERMINAL
STREET_NUMBER
2025
Direction
W
STREET_NAME
HAZELTON
STREET_TYPE
AVE
City
STOCKTON
Zip
95203
CURRENT_STATUS
01
SITE_LOCATION
2025 W HAZELTON AVE
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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Advanced CHAIN F CUSTODY RECORD <br /> GeoEnvironmental, Inc. /�/B�zG��L3q Oce Date Page �_ of <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-7118 <br /> Client Project Manager <br /> Tests Required <br /> 13,0 g ML7 <br /> PPone Nmb <br /> Q <br /> rAGE_a�': ( natu ) Invoice: <br /> Project Name � J �� <br /> Sample Type <br /> Sample Location Date Time Water Solid No. Notes <br /> Number Description Comp. Grab. Air Conts <br /> 32397 N <br /> t <br />* f, r <br /> 32398 <br /> 32399 ;- <br /> Rel e ign turaecerva y: netur —7 �\\ n,�ULrz A Date/Time <br /> Relinquished by: Signature Re ived by: (Sig lure) Daterrime <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Day Dalerrims <br /> s <br /> Dispatched by: (Signature) Dale/Time Received for Laboratory by: DaterTlme <br /> Method of Shipment: Vit,, Laborator Nerne <br /> Vit,, cam.. �vo�-���+--f"� <br /> Special Instructions: l� I/;n o; )I't, f I hereby authorize he performance of th above Indicated work. <br />
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