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ARCHIVED REPORTS_XR0008733
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_XR0008733
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Entry Properties
Last modified
7/7/2020 9:50:04 AM
Creation date
7/7/2020 9:42:21 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008733
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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CHAIN OF CUSTODY RECORD <br /> ( Oldvanced i <br /> - = GeoEnvironmental, Inc. q Dace /t-�s'-�_� Page ! of <br /> 837 Shaw Road-Stockton, California -95215- (209)467-1006- Fax (200)467-1118 <br /> ,tient WQler vo <br /> Project Mar�L er Tests Required <br /> Phone Number <br /> Samplers (Signature) invoice <br /> iro)ect Name �� AGE <br /> Client ❑ <br /> Sample Type • � <br /> Sample Location Date Time Water Solid No of Notes <br /> Number DescnpilonAtr Conts <br /> Camp (arab -r- _ <br /> Oto 1 110t0 i <br /> t, a <br /> 'i.4y��� h •r' ��,i <br /> 100 t <br /> ►otvl llolat 1�ti1 � � �C � �� <br /> v Maio r l05 <br /> �iltalo to►d) w03o ,k C <br /> '" t � t rd�e"� •M;�T,�S�r <br /> rn is e y ignature Received y gnatUre II''((1yA po f^f t a44 ?, � siu3} <br /> VOA qo M[V1C� % ate/r}m <br /> le� if�FJf / PR crI JIT ION 11-mss-o <br /> L uis ed by (Signature) Ret glued by (Signature) 1'(��('(��"J�i}n � , Date/Time <br /> r r <br /> Inquishe by (Signature) Received by Mobile Laboratory for field analysis (Signature COS oateMine <br /> i <br /> patched by (Signature) Date/timeRee a for Lpborat b /r te/Time <br /> shod of Shipment Aboratory Name <br /> L Over C4 <br /> ictal Instructions I hereby a horixe the performance of the above Indicated work <br />
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