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CO0051757
Environmental Health - Public
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RIO BLANCO
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2500 – Emergency Response Program
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CO0051757
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Last modified
3/3/2021 3:01:25 PM
Creation date
3/3/2021 2:49:07 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CO0051757
PE
2546
STREET_NUMBER
11464
Direction
N
STREET_NAME
RIO BLANCO
STREET_TYPE
RD
City
STOCKTON
Zip
95219
APN
06606001
ENTERED_DATE
3/16/2020 12:00:00 AM
SITE_LOCATION
11464 N RIO BLANCO RD
RECEIVED_DATE
3/16/2020 12:00:00 AM
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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SJGOV\ymoreno
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EHD - Public
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CASTLE ANALYTICAL LABORATORY CHAIN OF CUSTODY <br /> Location: 2333 Shuttle Drive, Bldg 908/909, Atwater, CA 95301 Certificate No.2480 <br /> Mailing Address:2333 Shuttle Drive,Atwater,CA 95301 PAGE OF <br /> Phone: 209 384-2930 - Fax: 209 384-1507 <br /> Customer: o REQUESTED ANALYSES Method of Shipment: <br /> Address: D " L <br /> s U) <br /> Ci /State/ZIP: r C�ri3O Z W m °' z Notes: <br /> 0-N (V y� U m W <br /> Phone/ FAX: Zo , 07 ua a� <m <br /> ` W " z <br /> W J oProj#/ PO#/Global ID: a. d <br /> Report Attention: o <br /> I4 <br /> 9 <br /> Cr <br /> w mo Sampler Signature: <br /> I- <br /> 0 <br /> Sampler Printed: ( _ W o w z <br /> Lab ID# SAMPLE ID DATE TIME DESCRIPTION/LOCATION " m OBSERVATIONS/REMARKS <br /> 10 &4,tcv /C'J — -Z : oD L <br /> I <br /> I <br /> Signature Printed Name Date Company Name Total number o containers <br /> submitted to the laboratory <br /> Relinquished by: ( ' _ Turn Around Time <br /> Received by: Ui ter/HJ-- N o N\.n ,Z r" 24 Hour <br /> Relinquished by: 48 Hour Eil <br /> Received by: 3 Day E] <br /> Relinquished by: 5 Day (Normal) 0 <br /> Received by: Special: <br />
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