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ARCHIVED REPORTS_XR0005432
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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2402
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3500 - Local Oversight Program
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PR0545640
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ARCHIVED REPORTS_XR0005432
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Entry Properties
Last modified
5/5/2020 2:54:09 PM
Creation date
5/5/2020 1:34:10 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005432
RECORD_ID
PR0545640
PE
3528
FACILITY_ID
FA0003900
FACILITY_NAME
PACIFIC PRIDE COMMERCIAL FUEL
STREET_NUMBER
2402
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95204
APN
12506001
CURRENT_STATUS
02
SITE_LOCATION
2402 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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Advanced CHAIN OF CUSTODY RECORD <br /> yate 2-'w Page of <br /> GeoEnvironmental, Inc.enc � -�- <br /> - of Nwilrein California <br /> 1803 West March Lane Suite A-Stockton California 95207 (209)956-0264 Fax(209)956-0700 <br /> Client VW �(� �-�p� (�-5 Project Manager <br /> Tests Required <br /> F1 0A n <br /> Phone Number <br /> 2o,�) s -010 <br /> Samplers (Signature) Invoice <br /> AGE [ J <br /> Project Name �, ��S Client <br /> Sample Typek� <br /> Sample Location Date Time Water Solid No of � Y Notes <br /> Number Description Comp crab Air Conts � <br /> } <br /> [ r aV k r <br /> shed y (5i nalu a Received by (Signature) Date/Time r <br /> Relinquished by (Signature) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Recwved by Mobile laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Uatc/Time fiecciv or 'oratory by / Oate Tame <br /> abora[4/oJry�N_Jame <br /> Method of Shipment /���, r,�� /t/yi_� <br /> l/r t `� U V V LU` (���7 / <br /> n <br /> I hereby authoxe the Performance of the above indicated work <br /> Special instructions i <br /> P <br />
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