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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0505272
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Last modified
6/18/2020 1:13:44 PM
Creation date
6/18/2020 1:00:05 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0505272
PE
2953
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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CHAT! OF CUSTODY RECORt <br /> _ �,.• Geological'-Audit Services Inc . gate -(3� <br /> Fnrrmnmen�aTProtessionaIS ? ? �`� page _ ,of <br /> 1503 West March Lane,Suite A•Stockton,catitornia-95207 -(209)958.0264 <br /> s.— <br /> Men t ! Project Manager <br /> Pis E7wrctlt� f}"�c-�� I `� Tests Required <br /> ° t F"RYA Phone Number _ 0 <br /> 2-v1r., <br /> - U <br /> Samplers: (Signature) irnrolce: <br /> Pro'ect Mame <br /> A1u.iF71z((,W MovLnaW6- � M•It,,LwOAX— ���, 13eoAudit [ <br /> r elk" [ <br /> Sample Location Sample Type � <br /> Number Date Time — ~!Vater Solid NO °t Notes <br /> Description <br /> Comp. Grub- Air Coats. <br /> i <br /> ' P <br /> Ty <br /> . aft <br /> SAS <br /> 4 47 <br /> a In fled <br /> ecerveAP1y' r alu e / Data me <br /> etingvishod by;(gegrtaty o ,. <br /> '0 act o Ignatura) )Da Rima �J <br /> Astinqu s e by:(Signature) f �•f' <br /> A da! y Mobile Laboratory for tield analysis:{Slgnaiure) ats/rlm9 <br /> Ma <br /> Olspatclted by:{Signature) Dato/Time Floco vo or LSboralory <br /> spr Data/11trH <br /> Method of Shipment: <br /> --- _'_ Laboratory N4Lno <br /> Special Instructions; <br /> FLIff '• ��- ?'s"'= tr+w• t <br /> .e.a hereby authorize the <br /> performan • of the above Irrdleated worst. <br /> • a:• .:ice r <br /> HM SPACE Ar" °���f�r�M 7V r�'•. . <br />
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