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ARCHIVED REPORTS_XR0005178
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_XR0005178
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Entry Properties
Last modified
9/24/2020 12:33:04 AM
Creation date
3/17/2020 2:11:38 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005178
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
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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M M moil M M M M M M M M MM M M MM M <br /> • • CHAIN OF CUSTODOECORD <br /> ( Advanced <br /> -_ GeoEnvxronmental, Inc Date Page Of <br /> 837 Shaw Road-Stockton,California-95215-(209)467-1406- Fax(209)467-1118 <br /> aQ5-6 <br /> Client R er <br /> - t bof Tests Required <br /> r�NIM b-7- I aA�, <br /> Samplers (Signature) Invoice <br /> AGE <br /> Project Name �, Client ❑ <br /> 8 <br /> Sample Location Sample TypeSolid No f Notes <br /> Date Time Water <br /> Number Descriptioncamp Grab Ali Conts <br /> einqu�s a �gnature Receivedy ignature ate <br /> gn <br /> Relinquished b (Siature) Received by (Signature) Date ime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DaterTime <br /> Dispatched by (SIgnature) Datefrime Received for Laboratory by l ` Dater a <br /> Method of Shipment f�p�.//� `t Laborato Name ,+ <br /> FL f�Ve ;�1 toe <br /> Special Instructions ` t hereby authorize the parlormance of the above indicated work <br /> f <br />
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