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ARCHIVED REPORTS_XR0009713
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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P
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PERSHING
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4445
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2900 - Site Mitigation Program
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PR0541263
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ARCHIVED REPORTS_XR0009713
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Entry Properties
Last modified
4/13/2020 2:52:31 PM
Creation date
4/13/2020 2:15:36 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0009713
RECORD_ID
PR0541263
PE
2950
FACILITY_ID
FA0023640
FACILITY_NAME
PERSHING GAS FOR LESS
STREET_NUMBER
4445
Direction
N
STREET_NAME
PERSHING
STREET_TYPE
AVE
City
STOCKTON
Zip
95210
APN
11018006
CURRENT_STATUS
01
SITE_LOCATION
4445 N PERSHING AVE
P_LOCATION
01
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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4 <br /> 1 + <br /> NET Santa Rosa Division LOGIN CHECKLIST <br /> CLIENT: —' Ve&IN JOB#: LOG#06DR <br /> Project ID• <br /> Samples Received On ._ Checked in on <br /> 1) Custody Seals: NIA Present ❑ Absent ❑ Broken <br /> 2) Cham of Custody P <br /> resent Present ElAbsent #(s) <br /> Forms ❑ Incomplete <br /> 3) Type of packing material used. _ 0'[' "- <br /> 4) <br /> 4) Temperatures) I ' C Thermometer#(s) <br /> 5) Sample Container(s) [sd Intact ❑ Broken <br /> 6) Container Label(s) Match COC ❑ Do Not Match <br /> 7) Sample Volume VSufficient. ❑ Insufficient <br /> 8) Preservative(s) Correct ❑ Incorrect ❑ pH verified ❑ Res.Cl chk <br /> (CN & PHI-s) <br /> 9) Headspace (VOAs) None ❑ Present (list ID's I number vials affected) <br /> Sample ID # of Vials Sample ID # of Vials <br /> 1 Q) Form Completed By: Date: <br /> Attach s pe s acking slip to this form before routing <br /> Problem Resolutson: <br /> 1) ❑ Project Coordinator Verbally Informed on <br /> 2) ❑ Client Informed on BY <br /> Project Coordinator: Date Resolved: ❑Y ❑ N <br /> Comments <br /> garsdscBopnfrm <br />
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