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ARCHIVED REPORTS_XR0012260
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_XR0012260
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Entry Properties
Last modified
10/10/2020 10:06:26 PM
Creation date
7/9/2020 8:58:02 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012260
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
Scanner
LSauers
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EHD - Public
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� l�.I• � 1� � � � � >� ■■� �� � �� iifiifiw � ws� �� <br /> Advanced - - I j CHAINri OF CUSTODY RECORD <br /> " GeoEnvronmental, Inc Date Page --L of� <br /> V 1 t# Noitheix California <br /> 1803 West March Lane Suite A Stockton California 95207 (209)956-0264 Fax (209)956 0700 <br /> Client T Fl 11 i o Project Manager � � C� {v Tests Required <br /> I <br /> Phone Number(201) "� C T V 6 -I <br /> Samplers (Signature) Invoice <br /> AGE K <br /> Project Name �2/"1 �' Client ❑ <br /> Sample Location Sample Type Na of <br /> p Date Time Water Solid �� Notes <br /> Number Description Comp Grab Air Coots <br /> 3v <br /> 3 <br /> IOW - 3 3 �6 3 X x <br /> V w- �V01A <br /> e inqu y (Signature) Received by (Signature) Date/Time <br /> 7- <br /> S k V, �� f u g t 3,0 <br /> Relinquished by (Signal re) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Re ived r Laboratory y Date/Time <br /> Method of Shipment / Labor ory Name <br /> L a � d� e� o, �� � aS fly �a <br /> Special Instructions I hereby authorize the performance of the above indicated work <br />
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