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ARCHIVED REPORTS_XR0008719
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_XR0008719
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Entry Properties
Last modified
7/7/2020 9:49:42 AM
Creation date
7/7/2020 9:33:02 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008719
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 CUSTOD*ECORD <br /> I f <br /> GeoEnvironmental, Inc <br /> Date E� Page { of <br /> 837 Shaw Road - Stockton, California- 95215- (209) 467-1006 Fax (209) 467-1118 <br /> ClientPro ect,Manager <br /> r � Tests Required <br /> Phone Number <br /> 76uca-y- O0(a <br /> S plers (Sl re) Invoice <br /> Project Name ���d� AGE � <br /> y � Client ❑ <br /> Sample Location <br /> Date Time Sampl a Solid No of Notes Number Description comp Water r Air Conts <br /> V11 <br /> 15� Q-Z43 3 <br /> �sc C. oho <br /> eh q as e y ature) e—ce ve y ignature DatelTrme <br /> 0:&(L(os r tUk U <br /> Relinquished by (Signa ure) Received by (signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for held analysis (Signature) � � Date/Time <br /> VVV <br /> Dispatched by (Signature) Date/Time Received for Laboratory by DatelTime <br /> Method of Shipment j Laboratory Name <br /> Ck t it i � <br /> Special Instructions 1 here uthorize the parlor ante of the above indicated work <br /> I <br />
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