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ARCHIVED REPORTS XR0000765
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 XR0000765
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Entry Properties
Last modified
2/8/2019 10:48:01 AM
Creation date
2/8/2019 9:36:56 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000765
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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0' CHAIN OF CUSTODOECORD <br /> j Advanced <br /> _ Date Page Of-�--- <br /> --- GeoEnvironmentai, Inc. <br /> 837 Shaw Road -Fax (209)487-1118 <br /> -Stockton, California-95215-(209)467-1006 <br /> P oject Manager <br /> j Client { ,� U 4���y )/ Tests Required <br /> Phone Number <br /> Sam lers: (Signature) invoice: <br /> i � AGS <br /> Project Name V— Chen(ff <br /> Sample Type <br /> Sample Location Date Time Water I Solid No. of Notes <br /> Number Description comp. arab. Air Conts, <br /> i <br /> PINE <br /> a IcS f ` <br /> 0 P,31 <br /> Z'Z; r <br /> i <br /> e inquEs a y: ignature ece ve y: (Signature) <br /> D telTime <br /> bate e <br /> Relinquished by: (Signature) Received by: (Signature) lTj <br /> Relinquished by: (Signature) Received by Mob lie Laboratory for field analysis: (Signature) *� Data(Ttme <br /> DatelTime Aeeelved for Laborato y: Date[Time <br /> Dispatched by: (Signature) <br /> borai�y Name <br /> Method of shipment: C [ ' N ME T ct �- <br /> L <br /> eraby authorize the performance of the above Indicated work. <br /> Special Instructions: <br />
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