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ARCHIVED REPORTS_XR0012109
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_XR0012109
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Entry Properties
Last modified
10/10/2020 11:20:37 PM
Creation date
7/9/2020 8:50:30 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012109
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
Tags
EHD - Public
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CHAIN OF CUSTOAECORD <br /> � Advanced D��. 0` Page .of .� <br /> ^,'T GeoEnvironmental, Inc <br /> 837 Shaw Road-Stockton, California-95215-(209)467-1006- Fax (209)467-111 e 3 3 <br /> Client Project Manre <br /> Tests Required <br /> Phone Number <br /> Alb(C- /645 <br /> Samplers (Signature) Invoice <br /> Protect Name �� ACE <br /> Client ❑ <br /> a <br /> Sample Type <br /> Sample Location Date Time Water Solid No of , Notes <br /> Number Description comp arab Air Corns �Q a <br /> 001 AA Wqav A <br /> L_ IDY I 1 <br /> 6D c roS� v J� w f l <br /> ///v <br /> MW 7 02,07 0 12, I-t�s 74D <br /> e q is e y (Signalbre) Received y (Signature) Date/Time <br /> ingwshed by (Signature) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Dateffime <br /> Dispatched by (Signature) Date/time Received for Laboratory by Date ime <br /> Method of Shipment Labgr am <br /> /lf � <br /> Special Instructions >> I hereby thorize the performance of the above indrealad work <br />
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