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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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EHD - Public
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>_ e>_ ttttttt� ■tom � � m m m M MIM M <br /> Advanced CHAIN OF CUSTODOECORD <br /> I ed <br /> GeoEnvironmental, Inc. Date Ld 6 pS Page <br /> 837 Shaw Road-Stockton, California-95215-(209)487-1006-Fax (209)467-1118 v <br /> Client Project ManaW <br /> t, Bc Tests Required <br /> umber <br /> Samplers (Signature) Invoice <br /> Project Name's 3 AGE <br /> Client ❑ <br /> Sample Location Sample Type <br /> Number Description <br /> Date Time Water AIr Solid No of Coats Notes <br /> r1 —4;— . Comp Grab <br /> '-r;4 k)k <br /> 4 k l <br /> A- <br /> V --ZA 11scle's 1 XN1 <br /> V1') - v <br /> A--FT ' 1"Z'--As X 1 1 � <br /> e m uia d y (Signature) Recelvea 15y ignature <br /> �Da efTime <br /> Z <br /> A inquished y (Sign urs) Received by (Signature) Datefrrme Esr <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis {Signature) /; DetefTime <br /> Dispatched by (Signature) Date rime Received or Laboratory by DatafTime <br /> Method of Shipment La orator ams <br /> Special Instructions �� I hereby authorize the performance of the above Indic work <br /> e <br />
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