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ARCHIVED REPORTS_XR0005144
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_XR0005144
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Entry Properties
Last modified
9/24/2020 12:23:22 AM
Creation date
3/17/2020 2:57:41 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005144
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
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SJGOV\sballwahn
Tags
EHD - Public
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• ., <br /> Chain-of-Custody Number: A <br /> SEACOR .Chaiun-of-Custody Record <br /> -3 . y'� S+(, e <br /> SaC r A. 7°0 <br /> Project # f4ODiy-00I a 1 Task# C 1301 Analysis Request <br /> Project Manager ^ Ic" A C lkv <br /> Laboratory hrJr. <br /> Iiirrt-around time: —SIaYc>( + '4 ' S q Comments/ o <br /> -} <br /> Sampler's Name: j � „ u o c a �. -1 A <br /> cQ�, �, Instructions <br /> ' qr. yn ;003 <br /> Sampler's Signature: '� o c o _ 'o ,� <br /> Sample ID Date Time Matrix �9 F F_ -� �% X g w l°r a� H =' z <br /> S - AI (- X r1-� S X r <br /> s - - <br /> 63 X r <br /> S - Q, li-2_7 S X r <br /> S <br /> S - I L - C) �( r <br /> 5 6 X <br /> S - 3i - 4Z X <br /> Special Instructions/Comments: Relinq 'she by: Received by: Sample Receipt <br /> Sign Sign T Tbtal no.of containers 4 TrT <br /> Print 1G Print Chain of custody seals: <br /> Company S F_A Cc 2 Company /-74�" Rec'd good condition/cold: <br /> Time Zl k�!_ Date I --z9f 9 3 Time IL"5'y Date 17. 2L Conforms to record: <br /> Relinquished by: Received by: S E A CC, <br /> Sign Sign Client: <br /> Print Print -Se4 C E` `i�►.__ <br /> Client Contact: <br /> Company Company <br /> Time Date Time Date nt Sic. le-?3 3 <br /> Client Phonee Number:r: <br /> Date `. 3 Page_L of <br /> i <br />
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