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ARCHIVED REPORTS_XR0005032
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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M
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MOFFAT
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983
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2900 - Site Mitigation Program
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PR0507952
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ARCHIVED REPORTS_XR0005032
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Entry Properties
Last modified
9/16/2020 12:58:53 AM
Creation date
3/17/2020 2:08:54 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005032
RECORD_ID
PR0507952
PE
2950
FACILITY_ID
FA0007846
FACILITY_NAME
OLYMPIAN CFN
STREET_NUMBER
983
STREET_NAME
MOFFAT
STREET_TYPE
BLVD
City
MANTECA
Zip
95336
APN
22115006
CURRENT_STATUS
01
SITE_LOCATION
983 MOFFAT BLVD
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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Advanced CHAIN F CUSTODY RECORD <br /> \W !;' GeoEnvironmental, Inc. ( '`� ' Date 7 l'I cry_ page —1 of / <br /> 837 Shaw Road Stockton, California- 35215 - (208) 467 1006 - Fax(209)467-1118 <br /> Client Project Meager <br /> f Tests Required <br /> PPOne Rumber <br /> Ro 100 <br /> Sa piers (Signature) Invoice <br /> Project Name i9e � x'L�' AGE <br /> Client ❑ <br /> Sample Location pate Time Sample Type No of <br /> Number Description Water Air Solid Cants Nates <br /> Camp Grab <br /> 1 <br /> t , <br /> JAW 47 <br /> 5 <br /> e rn ui r gn re} ere ve y ignatureyr(){�i ( i r r •,i t ,r ate/Time <br /> VV 6'if fi 'r <br /> Resin wished by (Signatute) le—1 r t �Z >L 6v V <br /> i T Rec ad2' ' 1 <br /> yw <br /> i,L t� , i I` <br /> Rehnqurshed by (Signaturef <br /> J. fuLr,�u�if Rece�ved(d ,i ibi�el E�rborstory field enalysis (Slgnaturo} DatelTime <br /> Dispatched b (Signature) �` <br /> P Y i>atelTima ec ry I r abnraloSyt yy D <br /> �ate/Time <br /> Method of Shipment — ` t` <br /> Labo or y Na e <br /> Special inatruohons i hereby thorrxe the pe ormance of the above indicated work <br /> 1 h <br /> r <br />
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