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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
Scanner
LSauers
Tags
EHD - Public
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■�i f: tttti i i i i i i i i i i i <br /> Advanced CHAIN OF CUSTODY REC RD <br /> GeoEnvironmental, Inc. Date has o �� <br /> Page Of L_ <br /> 837 Shaw Road- Stockton, California- 95215- (209) 467-1006 - Fax (209)467-1118 , <br /> :hent W��� Project Manager <br /> 5{1k I— l Tests Required <br /> Phone Number <br /> roject Name <br /> Samplers (Signature) � _ <br /> - ` <br /> Invoice <br /> wakeirloo VOC& t'is� �' AGE 0 <br /> Client ❑ <br /> Sample Location Sample Type <br /> Number Description Date Time Water Solid No of <br /> Comp or Air ContS _ Notes <br /> G e y Ighefufe e0e ve <br /> y IgnBlure <br /> t1C CC Date/Tlme <br /> + qulshed by (Signature) <br /> Received by (signature) <br /> � GPRfRT� <br /> X�1177 II�4Ct]e Qate/Time <br /> in uished b ��IYiA1tYf.fiJ �� <br /> q y (slgnalu►e) Received by Mobile Laboratory for field <br /> Tim Date/time <br /> patched by (Signature) Date/Time Re v for Ireborator <br /> y Dale/Time <br /> hod of Shipment <br /> Lebo ory Name <br /> Ioial Instructions Ce <br /> I hereby authorize the <br /> performance of the above indicated work <br />
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