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CO0049820
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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WALNUT GROVE
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12500
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2500 – Emergency Response Program
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CO0049820
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Entry Properties
Last modified
11/12/2024 4:10:56 PM
Creation date
5/30/2019 3:17:55 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CO0049820
PE
2546 - Release/Spill Response (excluding Joint Team)
STREET_NUMBER
12500
Direction
W
STREET_NAME
WALNUT GROVE
STREET_TYPE
RD
City
WALNUT GROVE
Zip
95690
APN
00105007
ENTERED_DATE
5/16/2019 12:00:00 AM
CURRENT_STATUS
Active
SITE_LOCATION
12500 W WALNUT GROVE RD
RECEIVED_DATE
5/16/2019 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\lsauers1
Supplemental fields
Site Address
12500 W WALNUT GROVE RD WALNUT GROVE 95690
Tags
EHD - Public
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CASTLE ANALYTICAL LABORATORYCHAIN 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: PG&E Stockton a REQUESTED ANALYSES Method of Shipment: <br /> Address: 4040 West Lane o LL {J�Crz�dY2 <br /> City/State/ZIP: Stockton, CA 95204 w m � o z Notes: <br /> N n U ro <br /> Phone/FAX: (209) 942-1401 � a � m Q CO N o <br /> Pro#/ PO#/Global ID: H J > ? W o 'R <br /> Report Attention: Alex S eele D e Larsen Q ° ¢ a W m o m o <br /> U) Lu <br /> a O cD a! <br /> Sampler Signature: 0 m a y <br /> Sampler Printed. e �� 8 N W o 4 <br /> � Z <br /> w <br /> Lab IDX SAMPLE ID DATE TIME DESCRIPTION/LOCATION m OBSERVATIONS/REMARKS <br /> c,1 b 5-v.-1cc Ir.L--o t cn c A ✓ I <br /> Z -Z1 Kt V. tl; o\L � <br /> 'al'tal number of containers <br /> Signature Printed Name Date Time Company Name submitted to the laboratory <br /> Relinquished by: Ce _ Turn Around Time: <br /> Received by: _ 24 Hour E <br /> Relinquished by: 48 Hour 0 <br /> Received by: 3 Day <br /> Relinquished by: 5 Day (Normal) <br /> Received by: Special: <br />
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