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ARCHIVED REPORTS_XR0005148
Environmental Health - Public
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EHD Program Facility Records by Street Name
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MONTE DIABLO
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1766
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2900 - Site Mitigation Program
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PR0535112
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ARCHIVED REPORTS_XR0005148
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Entry Properties
Last modified
9/23/2020 11:58:57 PM
Creation date
3/17/2020 3:00:33 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005148
RECORD_ID
PR0535112
PE
2957
FACILITY_ID
FA0020296
FACILITY_NAME
CHAPIN BROTHERS INC
STREET_NUMBER
1766
STREET_NAME
MONTE DIABLO
STREET_TYPE
AVE
City
STOCKTON
Zip
95203
APN
13505050
CURRENT_STATUS
01
SITE_LOCATION
1766 MONTE DIABLO AVE
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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r r r r r r r r r r ■� r r �■■ r r r ,..r rr <br /> Advaficed <br /> CHAIN OF CUSTODACORD <br /> l� �r l � <br /> GeoEnvironmental Inc Date S -1 <br /> - rPage of <br /> 4005 North Wilson Way Stockton, California-95205-(209)467-1006-Fax(209)467-1118 <br /> ta x u <br /> Clientf roject Manager <br /> Tests Required <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> AGEE;( <br /> Project Name u k Client ❑ <br /> Sample Location Sample Type No of <br /> Number Description Date Time Water Air Solid Conts t Notes t <br /> Comp Grab r <br /> W60 ,/ f 86907 <br /> il�� itis f ! 06908 ` <br /> } <br /> 86909 <br /> i <br /> q e Y ( ,g eo rve y Signature)_ —r�rteLme <br /> Relinquished by gnature) R wed by (SrgnalureJ Date rime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Date/Time <br /> Method of Shipment Laboratory Namy.� <br /> nA ��++ Crit Tug <br /> Special Instructions VOAS O&U METALS OTHER I hereby authorize thi performance of the above indicated work <br /> 01 PREMATIO <br /> GOOD CONDITION-:!C— APPROPRIATE a <br /> HEADS -C8N <br /> 1 <br />
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