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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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� � iiiiili= = Ml <br /> � i <br /> ( Advanced CHAIN OF CUSTOAECORD <br /> GeolEnvironmental, Inc, Date IY` ° Page of <br /> 837 Shaw Road- Stockton,California- 95215 - (209)467-1006- Fax(209)467-1118 ^J <br /> Client Project Managgeri <br /> Tests Required <br /> 7 q <br /> Samplers (Signature) Invoice <br /> _ r / <br /> Project Name AGEI _ <br /> Client <br /> Sample Type <br /> Sample Location No of [y W <br /> Number Description Date Time Water Air Solid Conts Notes <br /> Comp Grab <br /> 1L� - <br /> ; - 75 <br /> 1 kkW -15 lows4 <br /> e fnquw e y Sig cure terve y ignature D e(Cima <br /> ty 5 <br /> Relinqu shed by ( -rule) Received by (Sionature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) � l Datelrpme - <br /> Dispatched by (Signature) Datelrime ved for Laboratory by^ Data/Time <br /> Method of Shipment lab tory Name ��++ <br /> ---d I /I <br /> Special instructions r � I hereby authorize the performance of the able Indicated work - <br />
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