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ARCHIVED REPORTS XR0004695
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 XR0004695
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Entry Properties
Last modified
5/7/2019 9:24:52 AM
Creation date
5/7/2019 8:53:19 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004695
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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EHD - Public
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Advanced CHAIN Pf CUSTODY RECORD <br /> GeoEnvironmental, Inc Date Page (Yf� <br /> 837 Shaw Road - Stockton, California- 95215- (209) 467-1006- Fax(209) 457-1118 <br /> Client Proje Man r <br /> 1 f � Tests Required <br /> Phene Number <br /> lefs ignature) Invoice <br /> AG E-� <br /> Project Name Client C] <br /> Sample Type ,� <br /> Sample Location Date Time Solid No of <br /> Number Description Comp Grab Water Air Cots Nates <br /> ^ - 1310 <br /> e rnq is y { r9 at re ecewe yTT,-1;n—at-u--T- 0 t /Tim <br /> f Jlibif20 <br /> Rehnq fished by (Signature) Received by {3lgnature) f DatatTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by {Signature) Date/Time Received for Laboratory t]atelTlme <br /> �`'''� r <br /> G' <br /> Method of Shipment Laboral me <br /> i f <br /> Special Inons _ RtbAB -- I hereby au rze the a ormance o the above indicated work <br /> GOOD <br /> I LAD <br /> CL;>hP k , &---,T,,4 vi-� CA, 0 `.&P/ <br />
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