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ARCHIVED REPORTS_XR0010722
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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T
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THORNTON
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9110
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3500 - Local Oversight Program
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PR0545727
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ARCHIVED REPORTS_XR0010722
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Entry Properties
Last modified
6/4/2020 11:54:28 AM
Creation date
6/4/2020 11:28:04 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010722
RECORD_ID
PR0545727
PE
3528
FACILITY_ID
FA0005693
FACILITY_NAME
7-ELEVEN INC. STORE #20680
STREET_NUMBER
9110
STREET_NAME
THORNTON
STREET_TYPE
Rd
City
Stockton
Zip
95209
CURRENT_STATUS
02
SITE_LOCATION
9110 Thornton Rd
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
Scanner
LSauers
Tags
EHD - Public
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s X1780T'i'R'i; LA"IT`!0bUItiff R EEEEER3REr <br /> CONCORD, CA 94520 AND ANALYSIS REQUEST <br /> 510) 685-7852 �.S ►. �.,,,��.��, y „ fit•riir wy�t <br /> ENviROkMEN1Al , ,'j ,i f irti f �f li Tr <br /> w <br /> LASORAIOR113 INC (800 423-7143 �} �`��:�;j,'it i 1 I:jII , .'`.#r . �'� <br /> 1.f 4.4 ,S� n. <br /> Company Name Phone# <br /> ❑ ❑ <br /> FAX# ❑ z ❑ <br /> Company Address Site location Co <br /> cc <br /> Gy <br /> Ln <br /> Protect Manager Client Project ID (#) ❑ # + + `R a ❑ <br /> O2�3o�Zr ( m ❑ -- -� lu ° a N <br /> m m x a � v ¢ <br /> -JJf 14NAME rte.. I ❑ CI ❑ CI z 03 ❑ ❑ O <br /> I attest that the proper field sampimg Sampler Name(Print) # a ❑ o ❑ Q o E ❑ <br /> d15Ui <br /> procedures were used during the collectionc c7 ❑ N ❑ ❑ as a o q ❑ a a d <br /> of these samples ❑ 0 -- a ' 9 i a ❑ � �. <br /> -13 <br /> a <br /> ❑Method � o o <br /> ~Matrix Sampling <br /> Preserved o ❑ [1❑ J aN <br /> N- <br /> ❑P' CJRleld GTEL ❑ z ❑ <br /> @ aa 0Sample Lab # t wU ID Lab use only) ¢W 0 0 W <br /> Uz 0oa a a a a a¢ w a <br /> O aN d {— w w w w O3 to Q n iCO x x Oww <br /> Mw - 15c- 0 Z <br /> W4 - 13 0 0 v <br /> W 01 Iv ipJ <br /> Ix <br /> D <br /> iJ1 a <br /> 1-7i rij V 07 <br /> Y,1 - 11 e- <br /> .- IZC- 2- <br /> RU <br /> R13 w -- <br /> TAT Special Handling SPECIAL DETECTION LIMITS REMARKS <br /> Priority(24 hr) ❑ GTEL Contact <br /> Expedited(48 hr) ❑ Ouote/Contact N <br /> 7 Business hays ❑ Cantl►matlan N <br /> Other Co # SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot# Storage Location <br /> Business Das ❑ <br /> QA!QC LEVEL <br /> 13LUE❑ CLP❑ OTHER FAX❑ Work Order# <br /> Rellnqu d b ample D I Time Received by, <br /> I <br /> CE STO^v Relin hod by' date Time Recelved by <br /> RECORD� Relinquished by Date Time Received by Laboratory <br /> Cf? ,� �J10i•r�'`' <br /> _ / ' Wavbil # <br />
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