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ARCHIVED REPORTS_XR0005019
Environmental Health - Public
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EHD Program Facility Records by Street Name
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M
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MOFFAT
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983
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2900 - Site Mitigation Program
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PR0507952
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ARCHIVED REPORTS_XR0005019
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Entry Properties
Last modified
9/16/2020 12:30:57 AM
Creation date
3/17/2020 2:01:06 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005019
RECORD_ID
PR0507952
PE
2950
FACILITY_ID
FA0007846
FACILITY_NAME
OLYMPIAN CFN
STREET_NUMBER
983
STREET_NAME
MOFFAT
STREET_TYPE
BLVD
City
MANTECA
Zip
95336
APN
22115006
CURRENT_STATUS
01
SITE_LOCATION
983 MOFFAT BLVD
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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I ' I <br /> Advanced CHAIN OF CUSTODY RECORD , <br /> GeoEnvironmental Inc, 2W S Date� /�dc7` Page --J— of <br /> 0 <br /> 400S North Wilson Way Stockton,California-05205-(209)4&7-1008- x(208)487-1118 <br /> Client Project n32:r. <D. � Tests AeOed <br /> Ph1pne Number <br /> 1� <br /> Sample (Signature) Invoice: <br /> Project Name AGE Y <br /> Client 0 <br /> Sample Location ample Type �. <br /> Date Time N0' °� <br /> Number Description Water Air Solid Conts. Notes <br /> Comp. 8rab. <br /> 36901 F <br /> �W 4 �' „ . ' / :3� X }C i 36902 CD <br /> 36904 <br /> ! I <br /> m <br /> �C <br /> t <br /> Vq,n.,.,,1=ure <br /> : r•) ace+ve y: gna ur --Saz -1D-a <br /> te/timyy <br /> Received by: (Signature) Datefrime o <br /> v <br />' Relinquished by: (Si,gnatwe) Received by Mobil*Laboratory for field analysis. (signature) DaielTlme <br /> Dispatched by: (Signature) Date rima Received for Laboratory y: QalerTime <br /> I <br /> Method of Lhivinent., t�7e—P— C G [JeGy ,' l� _ Labv ator ame <br /> 1 � <br /> <v <br /> special inatructlonr. +ip f +r I h author ze the perfor once of the above Indicated work. N <br /> Flit L S <br /> rL:. ..l�Kt,i')•.i:7 it +t�)'��r;� ter ��~ " <br />
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