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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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( Advanced CHAIN OF USTODNIECOT <br /> GeoEnyironmental, Inc. I g2 J�` Date O� Z © Page a of <br /> J:5 <br /> 4005 Norlh Wilson Way-Stockton,California-95205-(209)467.1006-Fax(209)467-1118 <br /> I <br /> Client S �� Project Manag7;�/ <br /> IL�� - r` Tests Required <br /> Phone Number <br /> 01 I— <br /> Samplers, (Signature Invoice, <br /> Project Name d h AGE X <br /> k Client Sample Type <br /> Sample Location No of <br /> Number Descrtptton Date Time Water Air Solid Conts Notes <br /> Comp Grab i <br /> 4A 1k) M. 2-9803i z :zz <br /> 40 -3 q., -- 2984 <br /> ©W 29808 <br /> N 29806 <br /> 29887 <br /> 29808 <br /> kvJ-4- -3 1r zs 29809 <br /> e s e y ign re-Zi Received y (Signature I <br /> Retinq hed by (Signature) Received by (Signature) /T Date/Time <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 S `© Laboratory Nam <br /> YnAS9�RlnrHn <br /> lard � S <br /> [�•� f <br /> Spectat tnstruchons f hereby authorize the perform nce of the above indicated work <br /> HMO SPACE ABSENT-- Co INER" % <br /> GOOD CONDi�ION�.....�„_ APPROPRIATE <br />
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