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ARCHIVED REPORTS_XR0008726
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_XR0008726
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Entry Properties
Last modified
7/7/2020 9:57:46 AM
Creation date
7/7/2020 9:38:10 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008726
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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EHD - Public
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OPOSSUMS <br /> �.■ ■� a�� ifs � �� fi, � � � � � I� <br /> ( Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date Page I- 01 <br /> 637 Shaw Road -Stockton, California-95215-(209)467-1006- Fax (209)467-4118 2 <br /> Client PT <br /> feria er , Tests Required <br /> i Its, G <br /> Phone Number <br /> %7 161% <br /> Samplers (Signature) Invoice <br /> ��'�'� �� �' <br /> Project Name AGE_] <br /> n Client ❑ <br /> Sample Location Date Time Sample Type Solid No of <br /> Number Description Water Air Conts Notes <br /> Comp (crab �r � � <br /> w6- o` 30n 3 MLJSb I `,o1)� I /I —V <br /> 111,146 L0592 76 3 MLJ44 '5 ley <br /> 4J(A)AQS9L7()3 Mw <br /> e i u1shed b gnature Received by (Signature) Da alTime <br /> Relinquished b Si nature .' } <br /> q y l 9 ) Received by (Signature) Date►Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Tims <br /> Dispatched by (Signature) Date[Time Received for Labor ryby ] DatelTime <br /> Method of Shipman Labg#4toyy fit e <br /> Spec►allnsttucttions I hereby uthorize the performance of the above Indicated work <br /> (J <br />
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