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ARCHIVED REPORTS_XR0008453
Environmental Health - Public
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EHD Program Facility Records by Street Name
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W
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WATERLOO
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4648
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3500 - Local Oversight Program
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PR0545864
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ARCHIVED REPORTS_XR0008453
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Entry Properties
Last modified
7/21/2020 10:00:02 AM
Creation date
7/21/2020 9:53:31 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008453
RECORD_ID
PR0545864
PE
3528
FACILITY_ID
FA0004530
FACILITY_NAME
MARLOWE PROPERTY
STREET_NUMBER
4648
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95215
CURRENT_STATUS
02
SITE_LOCATION
4648 WATERLOO RD
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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atffw tatttattt� t�� t�� rAl�w� fti11111A �■ � �� tliiiiii� i� � afi>� �� � f� stlwr t>� wl■ <br /> (�? *Advanced <br /> CHAIN OF CUSTOD <br /> CORD <br /> GeoEnvironmental, Inc Date Page l <br /> 4005 North Wilson Way Stockton,California-95205-(209)467-1006-Fax(209)467 1118 <br /> Client Project Manager <br /> T. CV Tests Required <br /> Phone Number <br /> 2oq. 4 ti o0 <br /> Samplers (Signature) Invoice <br /> Project Name AGE <br /> Client ❑ <br /> Sample Location Date Time Sample Type Solid No of � , <br /> Water � Notes <br /> Number Description Comp crab Air Conts <br /> VA os tr4fwc'Unn will t � <br /> Vida ti <br /> Relinquish e ySignature) Tleceived by (Signature) ,r <br /> � A#JDDale(Time <br /> AP•o 90 <br /> Relinquished •quished by (Signature) Received by (Signature) Date/ tme <br /> J16114 � <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Da e/Trme <br /> Dispatched by (Signature) Dale/Time Received for Laboratory by Date/Time <br /> Method of Shipment Laboratory Name <br /> v1ptitcy Wiod '! PA el;-r.(04 lug <br /> Special Instructions 1 hereby authorize the performance of the above indicated work <br />
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