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ARCHIVED REPORTS XR0000759
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 XR0000759
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Entry Properties
Last modified
2/8/2019 10:09:32 AM
Creation date
2/8/2019 9:28:58 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000759
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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i� i>• i� � � i� � i� � i� i�r � i� iiiiii■� [ i���-- � <br /> CHAIN OF CUSTOARECORD <br /> Advanced -� <br /> Date Page Of — <br /> GeoEnvironmental, Inc. <br /> 137 Shaw Road Stockton, Cali#ornia 95215 - (209)467-1008- Fax(209)467-1118 <br /> Client ( PSM er Tests Required <br /> P.honeumber <br /> Sam rs: (S' riat e) Invoice: <br /> AGE <br /> Project Name � � t'/ orient ❑ <br /> Sample Type No.of <br /> Sample Location pie lme Water Solid Notes <br /> Number Description Comp. Grab. Air Solid <br /> Z- d� U �3 <br /> e inqu s e y' �I atReceived y: (signature) DatelTime <br /> Rellnqu shed by: (Signature) Received by: (Signature) Date(Time <br /> I <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(Signature) / Dateffime <br /> Dispatched by: (Signature) Date[Time Received for Laboratory by: Daitefrime <br /> f 1-14 <br /> Method of Shipment: Laboratory me <br /> 1 hereby authorize 1h o tarmance of the above indicated work. <br /> Special Instructions. <br />
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