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ARCHIVED REPORTS_XR0008118
Environmental Health - Public
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3500 - Local Oversight Program
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PR0545641
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ARCHIVED REPORTS_XR0008118
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Last modified
5/5/2020 3:42:23 PM
Creation date
5/5/2020 2:20:30 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008118
RECORD_ID
PR0545641
PE
3528
FACILITY_ID
FA0002480
FACILITY_NAME
SHOP N GO 3
STREET_NUMBER
4511
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
11023011
CURRENT_STATUS
02
SITE_LOCATION
4511 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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McCamell Analytical Inc. • <br /> p y pig° 1 of 1 <br /> 110 Second Avenue South,#D7 RAIN-OF-CUSTODY RECORD <br /> Pacheco,CA 94553-5560 <br /> (925)798-1620 WorkOrder. 4208411 <br /> Client <br /> Advanced GeoEnvironmental, Inc TEL (209)467-1006 <br /> 837 Shaw Road FAX (209)467-1118 <br /> Stockton, CA 95215 ProlectNo Pacific Mini Mart <br /> PO 23-Aug-02 <br /> -— -----� Requested Tests -- — - - <br /> Sample ID ClrentSamplD Matnx Collection Date Bottle 5M4500H+B SW8015C 8021BI8095 -._- � I � J <br /> 0208411-009 Influent Water 8/22/02104500 AM g - <br /> 0208491-002 Effluent Water 1 8122102 10 30 00 AM C B A <br /> Comments- <br /> --- -— --— - - Date/Time _ - -- Date/Time , <br /> Relinquished by _ _ Received by. <br /> Relinquished by, — Received by <br /> Relinquished by _ Received by <br /> !VOTE Samples are discarded 60 days after results are reported unless other arrangements are made Hazardous samples will be returned to client or disposed of at client expense <br /> Bottle Type L-titer V-Voa S-Soil Jar 0-Orbo T-Tedlar B-Brass P-Plastic OT-Other <br />
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