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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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�r fw.� t>,wr w■ t, t_ 1, iiiiiiiii� f� <br /> 9 CHAIN FUSTODY MORD <br /> �l Advanced Date Page of <br /> _- GeciEnvzronmental, Inc <br /> 4005 North Wilson Way Stockton,California-95205 (209)467 1006 Fax(209)467-1118 <br /> Client <br /> Project Manager,/ Tests Required <br /> ! G <br /> Phone Number <br /> Sam p s (Signature� Invoice <br /> AGE La <br /> Project Name Client 0 <br /> Sample Type No of <br /> Sample Location Date Time Water Solid Notes <br /> Number DescriptiOP <br /> camp Grab Air Conts <br /> V !� Cr �� •��� x <br /> Received ignature DateKmee <br /> 7Reh <br /> 2qu <br /> e ( gnature) Y <br /> i <br /> S70wP�0 D to/Time <br /> ed by (Signature �E�:!: Received by {Signature) <br /> DatelTlme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) <br /> Date/Time carved r Laboratory by teJTime <br /> Dispatched by (Signature) ( A+ J <br /> 2`� <br /> Laborat m <br /> Method of Shipment <br /> r <br /> I hereby authorize the performance of the above Indicated work <br /> Special Instructions <br /> C e T <br />
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