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ARCHIVED REPORTS_XR0008724
Environmental Health - Public
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EHD Program Facility Records by Street Name
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W
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WATERLOO
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3032
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2900 - Site Mitigation Program
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PR0537118
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ARCHIVED REPORTS_XR0008724
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Entry Properties
Last modified
7/7/2020 9:53:11 AM
Creation date
7/7/2020 9:36:27 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008724
RECORD_ID
PR0537118
PE
2957
FACILITY_ID
FA0021303
FACILITY_NAME
WATERLOO FOOD & FUEL
STREET_NUMBER
3032
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95205
CURRENT_STATUS
01
SITE_LOCATION
3032 WATERLOO RD
QC Status
Approved
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LSauers
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EHD - Public
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i <br /> C <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeciEnvironmental, Inc. Date ' 2� Page of�! <br /> 837 Shaw Road - Stockton, California-95215-(209)467-1006-l=ax (209)487-1118 <br /> Client Project Manager <br /> b, e— Trots Required <br /> P one Limber <br /> Samplers (Signature) Invoice <br /> Project Name ` J (' AGE <br /> Client p <br /> Sample Location Sample Type No of `� <br /> Number Description Date Time Water Air Solid Conts Notes <br /> Comp (arab <br /> OAlp I I <br /> 2 a �3�' <br /> mf66 <br /> i <br /> e inquature Received y (Signature) � � OtefTi e��� <br /> Relinquished by (Signature) Received by (Signature) Datellime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DaterTime <br /> Dispatched by (Signature) Date/Time Received far Laboratory by Date/Tlme <br /> 4,79 <br /> , 9 <br /> Method of Shipment � Laboratory <br /> i <br /> t <br /> Special instructionsL r/ I hereby authorize the performance of the above indicated work <br />
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