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ARCHIVED REPORTS XR0004693
Environmental Health - Public
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EHD Program Facility Records by Street Name
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M
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MADISON
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423
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3500 - Local Oversight Program
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PR0544427
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ARCHIVED REPORTS XR0004693
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Entry Properties
Last modified
5/7/2019 9:22:26 AM
Creation date
5/7/2019 8:52:20 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004693
RECORD_ID
PR0544427
PE
3528
FACILITY_ID
FA0004581
FACILITY_NAME
CHASE CHEVROLET*
STREET_NUMBER
423
Direction
N
STREET_NAME
MADISON
STREET_TYPE
ST
City
STOCKTON
Zip
95203
CURRENT_STATUS
02
SITE_LOCATION
423 N MADISON ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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SJGOV\wng
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EHD - Public
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( Advanced CHAIN ,OF CUSTODY RECORD <br /> GeoEnvironmental, Inc Date5"_3 page <br /> 837 Shaw Road Stockton, California- 95215- (209) 467-1006 - Fax(209)467-1118 <br /> Clientr d Project M HLagar <br /> Tests Required <br /> lk Phone NLynber <br /> Samplers (Signature) Invoice <br /> Prosect Name � �� <br /> /��� Circ �t V`� AGE,, <br /> p Client ❑ <br /> Sample LocationSample Type �� <br /> Number Description Date Time Water Solid No of a <br /> corny arab Air Conts Notes <br /> m <br /> to tgeas a3 Pi w JC('8 �� 7 <br /> was o e a0 /I5 <br /> 9 <br /> e 4 uis a ( rgnature41— <br /> •ace ve y rgnature <br /> �ate/Time <br /> Re rnquished by (Srgnatur Received by (Signature) ly3e eaorni <br /> pate(Time <br /> Rehnqutshed by (Signature) Received by Mobile Laboratory for field analysis (Signature} <br /> Dste(Time <br /> M i <br /> Dispatched by (Signature) Date/Time Received f boratory <br /> � ele(Time <br /> �� Ga I <br /> Method at Shipment Laborato?Nam <br /> 6pectaf tnsttuctions � � �•r• i <br /> I hereby a thou a the performance of the above indicated work <br />
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