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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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MILLER
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26239
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3000 – Underground Injection Control Program
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PR0523216
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COMPLIANCE INFO
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Entry Properties
Last modified
4/9/2020 3:57:32 PM
Creation date
4/9/2020 3:07:36 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3000 – Underground Injection Control Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0523216
PE
3030
FACILITY_ID
FA0015679
FACILITY_NAME
BFC PROP - UIC DRUG LAB
STREET_NUMBER
26239
Direction
E
STREET_NAME
MILLER
STREET_TYPE
AVE
City
ESCALON
Zip
95320
APN
22704003
CURRENT_STATUS
01
SITE_LOCATION
26239 E MILLER AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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tiltul'as <br /> L Chain u f CustodIZ <br /> l/ ccorclAllufas <br /> Analytics Log-h)# <br /> Inc. 1252 :Vfuras Uric, 11lnscnlN Ill 83843 (208) 883-3100 FAX Sat-'92-46 <br /> Company Name. Ground Zero Analysis, Inc. Project Manager: T_ <br /> John Lane Turn Around Titne & Reporting <br /> Address: 1714 Main Street Sampler Signature: <br /> Cit ❑Next Day" Results needed b ❑Phone <br /> Y: State. Zi�: Project Name& #: y <br /> Escalon CA t 95320 ) Berberian Miller ❑2nd Day* Elm il <br /> Tel: 209 838 9888 Fax: 209.838.9883 Purchase Order#: 0 Normal E]Fax <br /> 644-J PL Q E-mail <br /> E-mail.jlane@groundzeroanalysis.com Shipped Via/Other: 'Please call to verify rush charges <br /> FedEx before submitting samples <br /> Provide Sample Description List Anal ses Re uested Note Special Instructions/Comments <br /> Wastewater sample Preservative. <br /> --- Please indicate units to be reported <br /> NE V <br /> ° to <br /> as appropriate <br /> o <br /> CQ) L L N <br /> Lab ° a a a -0 <br /> U a mo E a) <br /> E m .a� t `o <br /> ID Sample Identification Sampling Date/Time Matrix ° m ° 3 E o r <br /> 't U) i,- U) "- s H U n (Typically results are reported down to.01 pg/100cm'or.01 pg/ft') <br /> BM-Tank 1 10/21/04, U*-3 Water 1 1L ✓ <br /> ieu e efll��n co lei <br /> of✓� t C� I'U C / ✓n <br /> "Z e rp <br /> Signature Printed Name <br /> Company Date Time Lab Use Only <br /> Relinquished by J o — V q (Received Intact? <br /> S cit e Z (sro�••?� 2e�o �O� i Z=o0 (A NO <br /> Received by Labels&Chain Agree? <br /> / Containers Sealed? NO <br /> ES NO <br /> Relinquished by Describe <br /> -------------------------------- <br /> Received by ---------------------------------------- <br /> R linquished by <br /> ------------- ----------------- <br /> ------------------------ <br /> --------------Pa e------ of-------- - <br /> Received by ---- - <br />
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