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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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20333
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3000 – Underground Injection Control Program
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PR0543383
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Last modified
10/25/2018 2:25:10 PM
Creation date
10/25/2018 1:06:11 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3000 – Underground Injection Control Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0543383
PE
3038
FACILITY_ID
FA0014468
FACILITY_NAME
MACHADO, JOE & LILLIAN
STREET_NUMBER
20333
Direction
S
STREET_NAME
AIRPORT
STREET_TYPE
WY
City
MANTECA
Zip
95336
APN
24132018
CURRENT_STATUS
02
SITE_LOCATION
20333 S AIRPORT WY
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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R <br /> Advanced CHAIN OF CUSTODY RECORD ', <br /> _ = GeoEnvironmental, Inc. Date f 8 3 Page Z- <br /> 837 Shaw Rosd -Stockton. Calitomla-9S218 -(289)467-1006-Fax(289)467-1118 `` N <br /> Client Project Manager i e Tests Required <br /> r <br /> Phone Number ,� � <br /> (XLLo <br /> Sample • (Slgnature} 41�f v 4mroice: <br /> 0' m •�' AG <br /> E <br /> Project Name I",/#/�AGyt+ del <br /> �J ¢a ` Clfettt <br /> r T <br /> Sample Location Date TimeEvamtiSolid No,at , N NatesNumber DesCriQtlanK COMMCamp. Qreb, m <br /> n <br /> LL—9 Sat,jtj LL� (0-19� 19 30 <br /> S- <br /> LCi 9 SWUre) eCe Ye �: 9fi8 Ilfe �aLAfT ma <br /> quie by; (Signeluce) Beaerved by:(Signature) detafTlrne <br /> rU <br /> ai inquIs hea by: (8ignalure) Receivad by•labile Laboratory 10F 1101d anr<lyeia: (Signature)Date/Time N <br /> N, <br /> ete{rlme a ve r sboratory Dats11 Imre 00 <br /> Dispatched by;(Signature) P <br /> Nlelhad a1 Shipment; oratory Hama G� <br /> Spacial Inalructlona: I hereby auiborlie the perfOrmaRCe of the ■bore Indicated work. A <br /> /4-4� , <br /> � A <br /> zz <br />
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