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ARCHIVED REPORTS_XR0008462
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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W
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WATERLOO
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3032
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2900 - Site Mitigation Program
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PR0537118
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ARCHIVED REPORTS_XR0008462
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Entry Properties
Last modified
7/7/2020 9:52:24 AM
Creation date
7/7/2020 9:29:05 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008462
RECORD_ID
PR0537118
PE
2957
FACILITY_ID
FA0021303
FACILITY_NAME
WATERLOO FOOD & FUEL
STREET_NUMBER
3032
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95205
CURRENT_STATUS
01
SITE_LOCATION
3032 WATERLOO RD
QC Status
Approved
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LSauers
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EHD - Public
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.� ei ww eats ttJ� tttttttttttll i♦ <br /> ( Advanced CHAIN OF USTOD ECORD <br /> = = <br /> GeoEnvironmental, Inc. -71 � �� Date—61/z7 0V Page 7, � <br /> 4005 North Wilson Way Stockton,California-95205-(209)467 1006-Fax(209)467-1118 <br /> Client S, Project Mana r <br /> t "t - � Tests Required <br /> Phone Number <br /> 701 -1 — 00 <br /> Samplers (Signature) `V Invoice <br /> ` f <br /> Project Name 04, �C' 6Vd nAT �� y AGE,Rf <br /> y� Client ❑ <br /> Sample Location Sample Type <br /> No of <br /> Number Description date Time <br /> Water : 9796 <br /> Air Solid Conts i�' -- <br /> Comp Grab <br /> nmy- <br /> � � H 2979i <br /> ZS' <br /> a� �`� d Lnt <br /> 29799 <br /> ,kA) -3 -- s t 1,0+ M 20804 <br /> JVJ D� �TtJ�` 29801 <br /> 1 <br /> 41,' q.t 29802 <br /> use IS- tura) starve V (Signature) 'j` f_ ,q <br /> !I ), atelTim <br /> Relrn ed by (Signature) Received by (Signature) AVdatelTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Dale/Time <br /> Dispatched by (Signature) DatelTime Received for Laboratory by DatetTime <br /> Method of Shipment � ,r.� ,rn�c O �ht c �Tu� Laboratory Nam � � b� <br /> Special Instructions �(„J} YUrtJ ItLJ `tl I hereby authorize the perfor ante of the above Indicated work <br /> GOOD CONDITII?N APPRaPflIA <br /> HEAD SPACE ABSENT— AI <br />
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