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ARCHIVED REPORTS_XR0005725 CASE 2
EnvironmentalHealth
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YOSEMITE
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2900 - Site Mitigation Program
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PR0545951
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ARCHIVED REPORTS_XR0005725 CASE 2
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Entry Properties
Last modified
9/24/2020 12:43:05 AM
Creation date
8/6/2020 11:28:52 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005725 CASE 2
RECORD_ID
PR0545951
PE
3528
FACILITY_ID
FA0003612
FACILITY_NAME
Yosemite Avenue Arco AmPm
STREET_NUMBER
1711
Direction
E
STREET_NAME
YOSEMITE
STREET_TYPE
Ave
City
Manteca
Zip
95336
CURRENT_STATUS
02
SITE_LOCATION
1711 E Yosemite Ave
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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LSauers
Tags
EHD - Public
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SE UQCAL,SAWLE RECEIPT LO <br /> t CLIENT NAIVS- L DATE Rece:vod ai Lab: Ontiiang water for r <br /> RE BY(PRLNT) _ 3 TW Reoerved at tab: _14 2r regulatory purposes: YE� O <br /> WOR ORDER" YI}'f j big JWOG TtiTi D ,TE: ! �0 3 Wastewazer for t <br /> regulatory purposes: 3'R f�QO <br /> CIRCLE THE AFJf'ltf?JPWA.TE IMPO TSPS LAB CONTAXn t S.A.M]P , XJAT)& )ESS: <br /> s SAI+iPL)� # CLT N'T JD UESCRI'k'TrON MATRIX SANPLED <br /> ca;r-nITza�N TC. <br /> 1 cusludySeals) PresentI F vti7 -- (� t1 <br /> Int�q ken* <br /> # 3.Z is R iporm or -f <br /> Iresm — <br /> 4 AubilL AsfEmI l aArr <br /> I�resent 1 3 <br /> 5.Airbtll 9: <br /> i <br /> 6 Swt ie Labels• !Absent <br /> 7. Sampic]Ds• a No;Listed <br /> 14 on Cham.-of�Gixstodv <br /> 8. Samplo Coadmon. r+ 3,rsken*I <br /> 9 Does information on , <br /> r,=Ddy,eporta,traffic f <br /> spats and su plc <br /> s <br /> # kbels a=e? <br /> i J.O. Ssmpk mvod vn#Ln r <br /> hold tme I Now I <br /> 11.Proper Preservatives <br /> used X /No* <br /> s <br /> 12 Temp Rec.at Lab ' <br /> LwaQ7 <br /> 4+l--2°C? Ergo** <br /> (Aamango for rniplas rc(ru=g th=al prca} <br /> *'En(if any) Metals!ZV l:'on tco?I DIFF nv lae? <br /> i <br /> lem CCC <br /> *If Circled,_contact project Manager=d attach reward if resofution. <br /> $8rnD14 Rmtpt Lag -- <br /> Rmsimi 2 3(1 V23= Page of <br /> Replaoes Revision 2 1(WI V02) <br /> 'ofd ver=4M2 <br />
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