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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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LOWER SACRAMENTO
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7920
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2900 - Site Mitigation Program
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PR0508154
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Last modified
3/3/2020 4:58:30 PM
Creation date
3/3/2020 4:56:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0508154
PE
2950
FACILITY_ID
FA0007962
FACILITY_NAME
VILLAGE PROPERTY
STREET_NUMBER
7920
Direction
N
STREET_NAME
LOWER SACRAMENTO
STREET_TYPE
RD
City
STOCKTON
Zip
95219
CURRENT_STATUS
01
SITE_LOCATION
7920 N LOWER SACRAMENTO RD
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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SO <br /> I �f CHAIN OF CUSTODY RECON, <br /> jZ Advanced � <br /> Ge oEnvironmental, Inc. Date Page of <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 <br /> ' Project Manager 0' <br /> Client � sv�� <br /> oS-� Tests Required <br /> Phone Number—/"die <br /> o� <br /> Samplers: (Signature) 'QO p Invoice: <br /> AGE [v� <br /> Project Name �D� � � //� - Client <br /> SampleType <br /> Sample Location Solid No. of <br /> Date Time Water <br /> Number Description Air Conts. <br /> Comp. Grab. 7i``y <br /> <52 <br /> y <br /> ,. .. <br /> S� <br /> �"--- <br /> �j -� G 5 1 <br /> �o <br /> rime- <br /> Re ingws y: (Wr e rve y: ignature Date/Time <br /> Reli 1 h byReceived by: (Signature) <br /> r� Date/Time <br /> Relinquished by: (Signature) !Received by Mobile Laboratory for field analysi $ .t (�ETIpLS OTHER <br /> Date/Time <br /> Dispatched by: (Signature) IVU Dara/Ti r Epi' cyby_ <br /> GOOD CONDITIOi� <br /> Method of Shipmen . — )' I LobofrlaI f y Na <br /> Special Instructions: I hereby authorize 11 perlormance of the above indicated work. <br />
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