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ARCHIVED REPORTS_XR0005015
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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M
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MONTE DIABLO
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1766
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2900 - Site Mitigation Program
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PR0535112
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ARCHIVED REPORTS_XR0005015
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Entry Properties
Last modified
9/16/2020 2:19:11 AM
Creation date
3/17/2020 2:56:14 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005015
RECORD_ID
PR0535112
PE
2957
FACILITY_ID
FA0020296
FACILITY_NAME
CHAPIN BROTHERS INC
STREET_NUMBER
1766
STREET_NAME
MONTE DIABLO
STREET_TYPE
AVE
City
STOCKTON
Zip
95203
APN
13505050
CURRENT_STATUS
01
SITE_LOCATION
1766 MONTE DIABLO AVE
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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( Advanced <br /> CHAIN OF CUSTODY RECORD <br /> -__- GeoEnvironmental, Inc °ateft 145! -/ Page of 4.1 <br /> 837 Shaw Road - Stockton California-95215- (209)467-1608 - Fax {209}467-1118 <br /> Client RW� TZI Protect Managerjjgg, Tent <br /> -F2 �� ( f' kF <br /> equfred <br /> Phone Number <br /> ,-49_ <br /> Samplers (Signature) Invoice <br /> Project Name 1 { - zwy ��L�_ r AGE <br /> '-= , � � � + Client ❑ <br /> Sample Location Sample Type No of x V <br /> Number Description Date Time Water <br /> Air <br /> Solid Conts Notes <br /> Comp Grab <br /> 11 <br /> Bell njuis e y (Signature) Received by (Signature) Da lTrme <br /> Relinquished by (Signature) Received by (Signature) I�� M � L S f Oats Ime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatelTime <br /> Dispatched by (Signature) Date/Time Received for Laborato by D e/Tlme <br /> to f <br /> ["-,12-1 o. <br /> e <br /> Method of Shipment Laboratory Name_ <br /> al I <br /> Special Instructions ����� ����� �1 ���{�`t `� (� � � I hereby authorize the perlormarce c the above indicated work <br />
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