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ARCHIVED REPORTS_XR0012025
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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W
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WILSON
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101
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2900 - Site Mitigation Program
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PR0541653
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ARCHIVED REPORTS_XR0012025
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Entry Properties
Last modified
10/10/2020 10:51:19 PM
Creation date
7/9/2020 8:28:16 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012025
RECORD_ID
PR0541653
PE
2965
FACILITY_ID
FA0023871
FACILITY_NAME
TOP FILLING STATION
STREET_NUMBER
101
Direction
S
STREET_NAME
WILSON
STREET_TYPE
WAY
City
STOCKTON
Zip
95205
APN
15125307
CURRENT_STATUS
01
SITE_LOCATION
101 S WILSON WAY
P_LOCATION
01
QC Status
Approved
Scanner
LSauers
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EHD - Public
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Advanced CHAIN OF CUSTW RECORD <br /> __= GeoEnvironmental, Inc. 1149q J0 L Date 3-2-6-f Page —L Of �- <br /> 4005 North Wilson Way Stockton,California-95205-(209)467-1006-W,(209)467 1118 <br /> Client r Project Manager , <br /> 0 1 � � Tf m C /tit Tests Required <br /> Phone Number � ! � <br /> 6 r� <br /> Samplers (Signature) invoice <br /> Project Name To Fd(i N Chert ❑ <br /> Sample Location Sample TypeDate Time Water Solid Na of N 1 <br /> Number Description Arr Cants '`� "' °" <br /> Comp (arab i� s {>S`'i 3i `�`" <br /> 6011, <br /> r JC x <br /> r 'q <br /> 12 .2-0 <br /> Y. <br /> 1( 12. 0 <br /> t ya� <br /> 3- �- <br /> 43 �PA <br /> (OV Ind- 2 —2C—F� (if <br /> eH n rs e, y ( igneture Rea�Ved (Sig re <br /> . 0010 <br /> Relinquished b (Signature) Received b (Signature) Daterrlme <br /> 9 Y ( 9 1 t 9 ) <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatetTime <br /> Dispatched by (Signature) Date/Timb Received for Laboratory by Date(Time <br /> Method of Sh[pmen t Laboratory Name <br /> � AluVD O t�hETAEs OTHER <br /> :� <br /> Special Instructions _ I here b authorize the performanc! of the above Indicated work <br /> GOD CQNDITI PPROPRIATE .� <br /> HEAD SPACE ABSENT CONTAINERS <br /> �.L 0�.�, �l oG( f'.,c,r-/saw c ek <br />
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