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ARCHIVED REPORTS_XR0006841
Environmental Health - Public
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EHD Program Facility Records by Street Name
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Y
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YOSEMITE
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420
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2900 - Site Mitigation Program
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PR0537485
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ARCHIVED REPORTS_XR0006841
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Entry Properties
Last modified
7/27/2020 7:00:21 PM
Creation date
7/27/2020 3:38:31 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006841
RECORD_ID
PR0537485
PE
2957
FACILITY_ID
FA0021568
FACILITY_NAME
FORMER RAINWATER CAR WASH
STREET_NUMBER
420
Direction
W
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
APN
21931206
CURRENT_STATUS
01
SITE_LOCATION
420 W YOSEMITE AVE
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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Advanced CHAIN OF CUSTODY ECORD <br /> GeoEnvtronmental, Inc l Dare Page �_ of <br /> C837 Shaw Road Stockton California 95216 - (209) 467 1006 Fax (209) 467-,IjlB <br /> Chent Pry ect Mana r <br /> –—_ — Testa Required <br /> P e ktumber <br /> - - – — Sa ers (Signature) Invoice <br /> Protect Name a— <br /> � K Gent ❑ <br /> I , <br /> Sample Location Sample Type No ofOrab 1 <br /> Number Description Date Time Water Air Solid Conts 1 89257 <br /> l <br /> 89258 <br /> 6_ A:L_ � o �� ,� , L� 89259 <br /> VD S 0&c MIETAtS OTHER <br /> — -— ] _nk A 11T Iv APO LATE <br /> MIMI:Al <br /> e n u e ( gnalure -- ane ve y gnature ! <br /> I 3(7 Data/Time i <br /> r ID <br /> elfnqulshe by {SrAnature Reca ved y (Signature) Date/Trme <br /> Ra inqu shed by {S gneture} Received by Mobile Laboratory for field analysis (Signature) Dale/Time <br /> I � <br /> Dispatched by (Signature) Oa1e171me <br /> As—calved for aboralory by Dale/Time <br /> Method of Shipment ti laboratory an <br /> iel <br /> Special tnatructiana� I hereby au rtxe t performance of the above Indicated work <br /> r <br /> ��AE'r- t't" E'P Itir�[ t ,�Yl If'f tCCC� ti/tC C' 1 C} <br />
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