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ARCHIVED REPORTS_XR0008092
Environmental Health - Public
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EHD Program Facility Records by Street Name
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P
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PACIFIC
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4405
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2900 - Site Mitigation Program
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PR0542364
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ARCHIVED REPORTS_XR0008092
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Entry Properties
Last modified
5/4/2020 3:46:25 PM
Creation date
5/4/2020 3:27:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008092
RECORD_ID
PR0542364
PE
2960
FACILITY_ID
FA0024340
FACILITY_NAME
PACIFIC CAR WASH
STREET_NUMBER
4405
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
11024014
CURRENT_STATUS
01
SITE_LOCATION
4405 PACIFIC AVE
P_LOCATION
01
QC Status
Approved
Scanner
LSauers
标签
EHD - Public
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( Advanced <br /> GeoEnvfronmental Inc. CHAIN OF CUSTODY RECORD <br /> Date 19t•'�-�-• �3 <br /> Page of <br /> 837 Shaw Road-Stockton, Callfornla-95215- (209) 467-1006- Fax (209)457-1118 <br /> Client J r-- Project Manager <br /> C.�e! Tests Required <br /> Phone Number <br /> ' <br /> Project Name Sa piers (Signature) <br /> Invoice <br /> --PA <br /> C-t+F �S L�• AGS <br /> OgR- <br /> Q Client <br /> Sample Location Sample Type �v� <br /> Number Description Date Time Water Solid No of r <br /> comp 1 Grab Air Corps ti Notes <br /> �1a�r r+'tQj 1u^�f! rv},►J+tq ! tq_ZZfs� ` � <br /> wlF / o ' <br /> e tnquts e y tg <br /> azure <br /> ecerve y ignature <br /> ' C DatelT+me <br /> Relinquish d by (Stgnaturey Received by (Signatura) ✓�� <br /> Date/Time <br /> Relinquished by (Signature) Received by Mob[[*Laboratory for field analysts (Signature) <br /> Date/Time <br /> Dispatched by (Signature) Oalelrima eiV40 for Laboratory by <br /> UatelTime <br /> Method of Shipment ;r <br /> c aboratoty Name <br /> Spac+st Instructions <br /> t hs►ob authorize the Pei rlormance of t e abov indicated work <br />
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