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ARCHIVED REPORTS_XR0008723
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_XR0008723
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Entry Properties
Last modified
7/7/2020 9:50:05 AM
Creation date
7/7/2020 9:35:56 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008723
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
Tags
EHD - Public
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•� �� � aaarr >- �� s ttttttttttw Iwi t� t� i i i f♦ I• f♦ <br /> ( Advanced <br /> CHAIN CUSTOD RECORD <br /> GeoEnvironmental, Inc. Date 4/4/0t/ Page "'"za—z— <br /> 837 Shaw Road -Stockton,California- 95215- (209)467-1006- Fax (209)467-1118 0c , <br /> 0 <br /> L� <br /> Client Project na r V <br /> Tests Required <br /> ,, <br /> P ne N r <br /> cz�qT <br /> ,4/6 7 /&Cz <br /> Sa (Sl ure) Invoice <br /> Protect Namek� <br /> AGE <br /> Client ❑ <br /> Sample Location Sample Type No of <br /> Date Time Water Solid Notes <br /> Number Description Comp Grab Air Conts <br /> e mqlu <br /> inet re - eceive y ignature ate rme <br /> G <br /> Relinquished By tSignatuie)jj Received by (Signature) Date/T:me <br /> Rehnqurshed by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatelTrme <br /> Dispatched by (Signature) DatelTime Recervad for Laboratory biL DatelTi e <br /> Method of Shipment ArlLa G- yN <br /> e <br /> YT-J12 <br /> Special Instructions ey e/ n V 1 hereby out rrze the (ormanee of the above Indicated work <br />
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