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ARCHIVED REPORTS_XR0003758
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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H
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HAZELTON
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375
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2900 - Site Mitigation Program
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PR0540905
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ARCHIVED REPORTS_XR0003758
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Entry Properties
Last modified
2/3/2020 9:55:07 PM
Creation date
2/3/2020 9:00:23 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003758
RECORD_ID
PR0540905
PE
2960
FACILITY_ID
FA0023406
FACILITY_NAME
SIERRA LUMBER MANUFACTURERS
STREET_NUMBER
375
Direction
W
STREET_NAME
HAZELTON
STREET_TYPE
AVE
City
STOCKTON
Zip
95205
APN
147120808
CURRENT_STATUS
01
SITE_LOCATION
375 W HAZELTON AVE
P_LOCATION
01
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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" l dvanced CHAIN 9F, CUSTODY RECORD <br /> GeoEnvironmentat, Inc. Cc� ` Date Vkk L, Page --L of( <br /> 837 Shaw Road - Stockton, California- 95215- (209) 467-1006- Fax (209)467-1118 <br /> Client Pro ect Manaaer <br /> Tests Required <br /> P e Number <br /> f <br /> Sa rs ( nature) Invoice <br /> Project NameAGE � . <br /> Client ❑ <br /> Sample Location Sample Type <br /> Number Description Date Time Water Solid No of Notes <br /> Comp Grab <br /> AJ <br /> COnfS <br /> vons �a <br /> 4- <br /> �il APPRO AFATE <br /> rL, ,i0l SPAC ABSENT CoynDUMS <br /> ATMYIN <br /> e n is s ig atReceived y ignature <br /> 19ate/Tlme,y <br /> Relinquished by (Signa ure) Received by (Signature) rl <br /> Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) 19.e_ <br /> DatefTime <br /> Dispatched by (Signature) Datef"hrrie Re el for t_abora ry b <br /> DatefTime <br /> s2 06 <br /> Method of Shipment LaborA o I me <br /> L <br /> 'M <br /> pecial Instructions _ ! I herebyauthor the a or nce of the above indicated work <br /> Q CC t v`CCS' l� �. fr p <br />
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