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ARCHIVED REPORTS_XR0011931
Environmental Health - Public
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EHD Program Facility Records by Street Name
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W
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WILSON
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101
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2900 - Site Mitigation Program
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PR0541653
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ARCHIVED REPORTS_XR0011931
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Entry Properties
Last modified
10/10/2020 10:48:20 PM
Creation date
7/9/2020 8:21:06 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0011931
RECORD_ID
PR0541653
PE
2965
FACILITY_ID
FA0023871
FACILITY_NAME
TOP FILLING STATION
STREET_NUMBER
101
Direction
S
STREET_NAME
WILSON
STREET_TYPE
WAY
City
STOCKTON
Zip
95205
APN
15125307
CURRENT_STATUS
01
SITE_LOCATION
101 S WILSON WAY
P_LOCATION
01
QC Status
Approved
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LSauers
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EHD - Public
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1Advanced CHAIN OF CUSTOD COOD <br /> GeoEnvironmental, Inc Date i 7 4C7 Page oaf <br /> C(�) ' :7" <br /> 837 Shaw Road-Stockton California-95215-(209)467-1006-Fax (209)467-1118 ) 2 y <br /> Client ect lidanW ! Tests Req red <br /> P umber A <br /> — 14io <br /> bRpieh <br /> Signature) Invoice <br /> Project Name AGE , <br /> Chenit <br /> Sample Location-., Sample Type <br /> Number Description <br /> Date Time Water Air Soled Conts Nates <br /> Comp Grab <br /> eTR ars r 4,7 1 <br /> 7 <br /> e mqui y agn tui acerve y ignature D to/Tome <br /> XZ <br /> Relinquished by (Signature) Received by (Signature) i � � <br /> Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Datef ime <br /> Dispatched by (Signature) Daie(Flme Received for laboratory by <br /> DatelTime <br /> Method of Shipment Labor Ama( <br /> . , <br /> Special instructionsv7 I hereby authoNze the rform nce of the above indicated work <br />
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