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FIELD DOCUMENTS
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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BACON ISLAND
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14200
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3000 – Underground Injection Control Program
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PR0524157
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Last modified
2/5/2019 3:27:30 PM
Creation date
2/5/2019 3:21:49 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3000 – Underground Injection Control Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0524157
PE
3030
FACILITY_ID
FA0016229
FACILITY_NAME
BARSOOM PROPERTY UIC
STREET_NUMBER
14200
STREET_NAME
BACON ISLAND
STREET_TYPE
RD
City
STOCKTON
Zip
95206
APN
12920012
CURRENT_STATUS
02
SITE_LOCATION
14200 BACON ISLAND RD
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
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Tags
EHD - Public
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Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvir©nmental, Inc. Date� Pap - of � <br /> - 837 Shaw Road- Stockton, California-95215 (209)467.1006-Fax(M)467-1118 0 2— <br /> 4 q7 <br /> Client A Project Manager _ Tests Required <br /> s. <br /> Phone Number <br /> Pol - Lib 7 - L-3(3(,::, <br /> Sam ler igowure) '� fir voice: <br /> Project Game AGE � <br /> '� ��LCA C!'terit <br /> `l <br /> Sample Type <br /> Sample Location No.of +? f <br /> Number Description mate lune Water Air Solid . Conts. Notes <br /> comp. Grab. <br /> 5TP s 01Z Renk <br /> A SCC-'4- 6V—�O.44A � z I <br /> e ed y:i nat ec�fv! y: .iynaiure atoftimd <br /> i" Rhe by: ( ignature) Received by: (Signature) DaWTime <br /> Relinquished by: (Signature) Received by Mobile i,aboratory for field analysls:iSignature) DaWrTime <br /> Dispatched by:(Signature) batelTime Reoelv#d for Laboratory by; f eta irne <br /> Method of Shipment: Laboratory Ham S <br /> CJ <br /> $peciale Instructions: Y here au.t rixe the performance of the above indicated work. <br /> Say'N L-. <br />
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