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ARCHIVED REPORTS_XR0008730
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_XR0008730
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Entry Properties
Last modified
7/7/2020 9:54:10 AM
Creation date
7/7/2020 9:40:58 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008730
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
Scanner
LSauers
Tags
EHD - Public
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� i <br /> (' Advanced CHAIN OF CUSTOD ECORD <br /> lop <br /> -__- GeoEnvironmental, Inc. Date Page - fOf <br /> 837 Shaw Road- Stockton, California-95215- (209)467-1006- Fax t209)467-1118 Q iC7 <br /> Client Project tviananeraJ DC7 <br /> 4 <br /> Tests Required <br /> Phone Number <br /> Samp ers Signature) Invoice <br /> Project Name AGE <br /> i <br /> #�XClient ❑ <br /> Sample Location Sa Type <br /> Date Time Water Solid No of Notes <br /> Number Description Comp Grab Air Conts <br /> AA10 Fe /J/4�83 tzLil - <br /> RU IAil 3 <br /> A 9 3 <br /> y i nature) Aecelved by ignature <br /> Date/T71(,10 <br /> A�� -fto-o3 <br /> quished by (Signature) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Dateffime <br /> n <br /> Dispatched by (Signature) Date/Time 7R0-� <br /> for Laboy DatalTime <br /> 11 _4 t� 1'?-0 3 a V4� <br /> Method of Shipment aboralory N <br /> Special Instructions 1 hereby authorize the performance of the above indicated work <br /> i <br />
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