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ARCHIVED REPORTS_XR0012023
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_XR0012023
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Entry Properties
Last modified
10/10/2020 10:50:14 PM
Creation date
7/9/2020 8:26:13 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012023
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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rr twr tfiiiiiiir tiiiir 1� .w. .�.. 1111111111111111011 .... <br /> 4r CHAIN O USTOD.. CORD <br /> Advanced � / <br /> _ Date Page --L_ of f <br /> GeoEnvironmental, Inc <br /> �— 4005 North Wilson Way Stockton,California 95205-(209)467 1006-Fax(209)467-1118 <br /> ger <br /> Client � �. Tests Required <br /> Phone Number <br /> Sa (Si ature Invoice <br /> AGE <br /> Project Name ��,�=�✓��� `� Client ❑ <br /> ✓✓✓ Sample Type <br /> Sample Location Date Time Water Solid No of Notes <br /> Number Description comp Grab Air Conts <br /> Grridll <br /> 'on IA4 w ILI .5o �� > <br /> X X I-AFaw <br /> o f qui e y igna a ecetve y ignalure DatelTrme <br /> Reh quished by (Signatu ) Received by (Signature) DatelTime <br /> Reltnquished by (Signature) Received by Mobile Laboratory for field analysts (Signature) IC Dale/Time <br /> Dispatched by (Signature) Date[Time Re rued to Laboratory by Date/Time <br /> Laborato Ne <br /> Method of Shipment <br /> QjgF I here authorize the performance o1 the above Indicated work <br /> Special instructions <br />
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