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ARCHIVED REPORTS_XR0005149
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_XR0005149
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Entry Properties
Last modified
9/23/2020 11:22:49 PM
Creation date
3/17/2020 3:01:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005149
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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Advanced 0 CHAIN OF CUSTODACORD <br /> L� - <br /> - - GeoEnvironmental, Inc Date Pae of <br /> -� <br /> 4005 North Wilson Way Stockton,California-95205 (209)467 1006-Fax(209)467-1118 1002-01 XR&935 <br /> Client �� Project Manager L-{ / T lie ufred <br /> G <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> AGE <br /> Project Name Q r Ir Client ❑ <br /> Sample Type � ti <br /> Sample Location No of <br /> Date Time Water Solid Notes�Z'_l <br /> Number Description Conts <br /> p comp Grab Air t . }y{ =� �� ;� <br /> W_ <br /> lie � X (r�. <br /> --� z 3 l���� � NO <br /> —17 <br /> M �V —q <br /> }� <br /> 1 - - 2 <br /> Re in urs ied by Signaiure) eceive y ig ture `tea s• ° - "��� <br /> 5 I<z- <br /> 7 <br /> �o �o 3:ao <br /> Relinquished by (Signature) ived by (Sign ture) , Datefrime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Date/Time <br /> Method of Shipment GLJt2 Laborat ry Napz <br /> [Ile iV- <br /> Special Instructionsp r' I hereby authorize t e per ormance of the above indicated work <br /> VOA; <br /> J <br /> YOON METALS OTHER <br /> t <br /> Gf)ODCONpi inu J APPROPRIATE <br /> 1*A W,1 ABSENT CONTAINERS-St— <br />
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