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ARCHIVED REPORTS XR0003372
Environmental Health - Public
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EHD Program Facility Records by Street Name
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COUNTRY CLUB
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2725
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3500 - Local Oversight Program
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PR0544596
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ARCHIVED REPORTS XR0003372
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Entry Properties
Last modified
6/24/2019 1:55:52 PM
Creation date
6/24/2019 1:32:31 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003372
RECORD_ID
PR0544596
PE
3528
FACILITY_ID
FA0002064
FACILITY_NAME
7-ELEVEN INC. STORE #14117
STREET_NUMBER
2725
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
CURRENT_STATUS
02
SITE_LOCATION
2725 COUNTRY CLUB BLVD
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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VVIAO/aa MUM LIST YAS U- GROUNI)IFATER i�j q l5 <br /> Ii E1 YrrtrolgrRllM FIasElt�Isntr tyi Plan. SOu2hlmrad 14117, Sl a c klem. CA. <br /> . Pau f oarflo Haallh and Plan In1limmmon .duh. i see <br /> AGREEMENT AND ACKNOWLEDGEMENT SHEET <br />++ Fluor Darriai GTI personnel have the authority to stop field Ocrw ties at Oft ske if any ac&4 ir.not <br /> I Perromwd in ardance v,Ath the requirements of this RP HASID. All Fluor Daniel GTI project <br /> J personnel,subcontractor pemonnel,and vWitars are required to qn the Agreement and <br /> Acknowledgement Sheet prior to conduc ling field edMes at tlhTs alta. <br /> =ZMA �� <br /> , 6 �r IS�' ' „ ■�i�Y1lffp44.1FW "°. =+I{ <br /> � <br /> 1. I have reviewed and fully understand Part A of this RIP HASP and my respansibilltlas. <br /> 2. 1 am aware th=additional.standardind health and saw informatlon Is available for <br /> :me in Part 13 of this RP HASP. <br /> 1 l areo to abide h the provisions of the RP HASP. <br /> Name ;?4 Gt r Si ratur s <br /> Company Date <br /> Name ,J � SI nature <br /> Carry Dula .( <br /> r <br /> Name S natura <br /> Corn Date <br /> Name S natura <br /> C.OmMky Data <br /> Name Signature <br /> C�xnMny Date <br /> I <br /> E <br /> t <br /> f <br /> no" 4TI <br /> rW1G629 <br />
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