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ARCHIVED REPORTS_XR0003762
Environmental Health - Public
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EHD Program Facility Records by Street Name
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H
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HAZELTON
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375
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2900 - Site Mitigation Program
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PR0540905
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ARCHIVED REPORTS_XR0003762
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Entry Properties
Last modified
2/3/2020 10:10:17 AM
Creation date
2/3/2020 9:06:33 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003762
RECORD_ID
PR0540905
PE
2960
FACILITY_ID
FA0023406
FACILITY_NAME
SIERRA LUMBER MANUFACTURERS
STREET_NUMBER
375
Direction
W
STREET_NAME
HAZELTON
STREET_TYPE
AVE
City
STOCKTON
Zip
95205
APN
147120808
CURRENT_STATUS
01
SITE_LOCATION
375 W HAZELTON AVE
P_LOCATION
01
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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� i i i i i i i i i � � i !♦ 1♦ illi i♦ <br /> ( Advanced CHAIN OF CUSTODY RECORD <br /> / <br /> Q0 Date "�3" Z Page tof <br /> GeoEn�ironmenta , Inc <br /> 837 Shaw Road - Stockton, California -96215- (209)467-1006- f=ax (209) 467-1118 <br /> Client 5_ - Project Manager <br /> Tk m Cve-N r Tests Required <br /> Phone Number <br /> aLOI- U-7- J CKQ(o <br /> Samplers (Signature) � 5 �q Invoice <br /> Project Name p AGE jig <br /> Client ❑ <br /> Sample LocationSame a <br /> Date Time Wa r Solid No of �W 4 �N Notes <br /> Number Description comp Grab Air Conts 4 <br /> W Z 1i2o3pz <br /> V I Zo392 Saellko� �Rece►dPd �3Z� <br /> �^ yb Izaz 1305 <br /> ow=1L0 <br /> Io5l <br /> Aefinq,lsh.;b�y <br /> �(S,igg�nature) <br /> nature eca ve y gnature <br /> Data/Time <br /> Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatelTime <br /> Dispatched by (Signature) DatelTime Rec ived ir Laboratory 1 ODa !rime <br /> Method of Shipment o,r.,_,�, !, - = Laborato Name <br /> Special instr "'�""'" , ��t ; Ehereby aut rtxe the performance of the above Indicated work <br />
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