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FIELD DOCUMENTS_FILE 1
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2801
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2900 - Site Mitigation Program
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PR0504943
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FIELD DOCUMENTS_FILE 1
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Last modified
6/17/2020 5:52:56 PM
Creation date
6/17/2020 3:11:01 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
FileName_PostFix
FILE 1
RECORD_ID
PR0504943
PE
2951
FACILITY_ID
FA0004032
FACILITY_NAME
AMERICAN MOULDING & MILLWORK (FRMR)
STREET_NUMBER
2801
STREET_NAME
WEST
STREET_TYPE
LN
City
STOCKTON
Zip
95204
APN
11709001
CURRENT_STATUS
02
SITE_LOCATION
2801 WEST LN
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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tidvanced G'HAIN O�IUST�DY RECORD . <br /> ` 1 ' GeoEnvironmental Inc., Date Page ? or <br /> 4005 North Wilson Way-Stockton,California,95205-(209)467-i 006=Fax(209)467-1118 <br /> Client <br /> Projej anacier <br /> Tests Required <br /> Phone Number ' <br /> Samplers: (Signature) - Invoice: <br /> Project Name Atl(( 6f.4A 1�'`G� �c;' r)�t I �{ -7 C-] <br /> J C-]j 1��� L,✓'C1G '' lC �' AGE <br /> -� <br /> Client ❑ <br /> Sample Location Sample Type:. . <br /> Number Description Date Time Water Solid No. of Notes. <br /> Com <br /> Air Conts. <br /> l y p. Grab. � <br /> � H , <br /> ` -� �` '�� '-, fj �`' ✓ ✓ ✓ 14191 <br /> d t 4 � 1�� 1419 2 <br /> 14193: <br /> `' ' — , 1'4194 <br /> I1-2�, - - �� � 14195' <br /> 141,96 <br /> r; <br /> ett quis e' y: ig7nazure stew y: (Signature) <br /> (p-aZu-9Ct Oate/Tima ✓✓✓ <br /> d$S Ci <br /> Relinquished y;'(Signature) Re ved by: (Sig ture) n c VOAS n etrrAl� e <br /> _ Relinquished by: (Signature) i ��+ n n PRESERVPON V IYIC'flL <br /> Received by Mobile Laboratory for field analysis:(Signature) �� L� U��U J ARESE RIF <br /> Dispatched.by: (Signature) aateMme Received for Laboratory y; U r UalelTime <br /> -� <br /> MethodofShipment: r <br /> . � � •�'[ -/� ��r 1.".�.... - _ Laboratory Name�L �� •,7��,C / / .. <br /> Special Instructions: a , ..� I hereby authorize the <br /> ' Y perfor ante of the above indicated work. <br /> 'i <br />
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