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ARCHIVED REPORTS_XR0005231
Environmental Health - Public
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EHD Program Facility Records by Street Name
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4040
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2900 - Site Mitigation Program
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PR0545496
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ARCHIVED REPORTS_XR0005231
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Entry Properties
Last modified
3/10/2020 9:06:16 AM
Creation date
3/10/2020 8:45:18 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005231
RECORD_ID
PR0545496
PE
2957
FACILITY_ID
FA0003564
FACILITY_NAME
BLUE STAR
STREET_NUMBER
4040
Direction
E
STREET_NAME
MAIN
STREET_TYPE
ST
City
STOCKTON
Zip
95205
APN
15727503
CURRENT_STATUS
02
SITE_LOCATION
4040 E MAIN ST
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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r r rr M M M r M M M M rr M <br /> • <br /> Advanced CHAIN OF CUSTODOECORD <br /> Date� <br /> GeoEnvironmental, Inc. Page of <br /> 837 Shaw Road - Stockton, California-95215- (209) 467-1006- Fax (209)467-1118 O Z/—S <br /> Client ��'� Project Manager �n <br /> Tests Required <br /> Phone Number <br /> T� <br /> Samplers (Signature) vInvoice <br /> Pro)ect Name {� I — / AGE 2- <br /> {->1 t Sd tie `� Client ❑ <br /> Sample Type <br /> Sample LocationSample <br /> Time Water Solid No of �� e � Notes <br /> Number DescriptionDate <br /> Grab Air Coats ,� <br /> MAI-ZS vukcwLL-PO 2 C z7l� 1,4q S�- <br /> tW 5-1) <br /> lMW2 3S tc 3�` loo �C �( xi <br /> A&W D ![ q6 )5os- <br /> MW 2- 5 <br /> MWz- so L( 1501 a%z5 <br /> A <br /> +g r+ re Receivedy ignatu►e DatalT+me <br /> S Z-off/ l'20� <br /> hed by (Si lure) I Received by (Signature) Date(r+me <br /> Relinquished by (Signature) Received by Mobile Laboratory for held analysis (Signature) " Date rime <br /> 117 <br /> Dispatched by (Signature) Datef ime Receiv d r aboral ateffrne <br /> Method of Shipment f`� , Laboratory Name <br /> 4 rCf Jh <br /> a the performance of the above Indicated work <br /> Special Instructions thereby autho <br /> Z/1 <br /> 4 <br />
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