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ARCHIVED REPORTS_XR0010305
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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3500 - Local Oversight Program
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PR0545688
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ARCHIVED REPORTS_XR0010305
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Entry Properties
Last modified
5/21/2020 3:06:15 PM
Creation date
5/21/2020 10:20:29 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010305
RECORD_ID
PR0545688
PE
3528
FACILITY_ID
FA0003634
FACILITY_NAME
CANTEEN CORPORATION
STREET_NUMBER
1500
Direction
N
STREET_NAME
SHAW
STREET_TYPE
RD
City
STOCKTON
Zip
95205
APN
14326008
CURRENT_STATUS
02
SITE_LOCATION
1500 N SHAW RD
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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LSauers
Tags
EHD - Public
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• • M <br /> Advanced CHAIN OF CUSTODY RECORD , <br /> �--- - 11 <br /> GeoEnyironmental, Inc, Date -'L`aw Page — ot_ _ <br /> 4005 North Wilson Way-Stockton,Gallfomia-95205 (209)467-1006-Fax(209)467-1 f 18 <br /> ClientPrate a or CD <br /> W&+ <br /> Tests Required <br /> nei umber <br /> 47 "66 <br /> b <br /> a rs, (Signature) � ti Invoice. <br /> IT AGE <br /> Project Name w <br /> �^ , � <br /> 1,.,f 'A�e." Coc �rac4 �, 0,e �, Client ❑ :5 <br /> Sample Location Sample ypo No. at .T• � � <br /> Number Description Date Time comW eQfab Air Solid Conts Jf: : Notes <br /> W1 /fZ l2w Mw -, I% 11/1110 Id y` 56005 (-r 1 ua <br /> MW 1,14Z12 11Mw- k%4 ►Zile '0c 5§006«" ED <br /> {►'1w13 iet�U l^'1LJ" 1 �/}2/tiesami <br /> � 56D07 � t) .� <br /> ria <br /> Air, ! I' S, f• r <br /> O <br /> rr CD <br /> _ <br />� � N <br /> 0 <br /> e i qu a jgn urs Received y (Signature) <br /> n <br /> VAL i1uMLf t <Dr Ems <br /> 1Z ix p� <br /> a n u shed <br /> —(-bl gnature Received by (619nature) gate/Time <br /> n <br /> nitinquishe y gnature) Received by Mobile Laboratory for field analysis (Signature) Dale/Time <br /> Dispatched by (Signature) Daleffime Received for LSDOFNI.Ory by <br /> � �1 �� Dalsfrlme <br /> In <br /> �C L1 r 40 0 f C �Z t <br /> Method of Shipment Laborsto m <br /> sv <br /> Special Instructions I hereby sulhorire th perlormanaa of the ova indicated worst <br /> A <br /> W <br />
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