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ARCHIVED REPORTS XR0000758
Environmental Health - Public
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EHD Program Facility Records by Street Name
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B
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BEVERLY
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104
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2900 - Site Mitigation Program
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PR0540667
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ARCHIVED REPORTS XR0000758
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Entry Properties
Last modified
2/8/2019 10:23:14 AM
Creation date
2/8/2019 9:26:38 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000758
RECORD_ID
PR0540667
PE
2960
FACILITY_ID
FA0023252
FACILITY_NAME
WELDON CHURCH PROPERTY
STREET_NUMBER
104
Direction
W
STREET_NAME
BEVERLY
STREET_TYPE
PL
City
TRACY
Zip
95376
CURRENT_STATUS
01
SITE_LOCATION
104 W BEVERLY PL
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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j <br /> CHAIN OF CUSTOE&ECORD <br /> Advanced <br /> GeoEnvironmental, Inc. Date <br /> 837 Shaw Road.- Stockton,California-95215-(209)467-1006-Fax(249) 467-1118 <br /> client PM Tests Required <br /> Phone <br /> San: (Sig u `�"', Invoice: <br /> Proiect Name Lf AGE ' <br /> � cum 171 <br /> Sample Type <br /> Sample Location Date Time Water Solid No.of �" Notes <br /> Number Description Air coats. <br /> 1 Comp. Grab. <br /> LK-7 <br /> t � <br /> No `3-- -f <br /> Zin na eceEve y: ignature Oate/Tim <br /> Relinquished by: ( i nature) Received by: (Signature) Daterrime <br /> Relinquished by: (Signature); Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) DatelTime Received for Laboratory by: Dateffime <br /> 24 An <br /> Method of Shipment: LaboyaVry Na e <br /> ,Special Instructions' 1,t 1 hereby authorize arformance of the above indicated work. <br /> 1 r'/ <br />
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