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ARCHIVED REPORTS_XR0012121
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_XR0012121
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Entry Properties
Last modified
10/10/2020 11:17:49 PM
Creation date
7/9/2020 8:56:11 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012121
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
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LSauers
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EHD - Public
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_ ■� e� � tfl� fid � ■�■ � � � � � �� I♦ <br /> Advanced <br /> CHAIN PF CLISTODAECOM <br /> GeoEnvironmental, Inc. Date 7/U Page �� <br /> 837 Shaw Road- Stockton, California- 95215 - (209) 467-1006 - Fax (209)467-1118 <br /> Clientr- Project Mana <br /> Q� Tests Required <br /> Phon Number II <br /> zMa lers lgnature) Invoice AGE Fr <br /> Project Name --T� �� Client E3 <br /> Sample Type <br /> Sample Location <br /> Date Time Water Solid No of Notes <br /> Number Description Comp I Grab Air Conts <br /> 44 — A5 <br /> X a2 <br /> I If <br /> e i is e y (S nature eceive y ignature at i g <br /> Relrriquished by (Sign 4Ye) Received by (Signature) alernme <br /> Relinquished by (Signature) Received by Mobile Laboratory for held analysis (Signature) Date/Trme <br /> Dispatched by (Signature) Datefrime Received for Laboratory by Date/Time <br /> c <br /> Method of Shipment Labor am <br /> (.1;:d� <br /> Special lnstruchon I hereby au horize a performance of the above indicated work <br /> � e� L <br />
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