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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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F
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4 (STATE ROUTE 4)
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15420
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3000 – Underground Injection Control Program
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PR0522107
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Last modified
11/20/2024 9:09:21 AM
Creation date
1/24/2020 3:49:37 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3000 – Underground Injection Control Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0522107
PE
3030
FACILITY_ID
FA0015067
FACILITY_NAME
TOGNINALI, ALDO & ROSALIE
STREET_NUMBER
15420
Direction
E
STREET_NAME
STATE ROUTE 4
City
STOCKTON
Zip
95215
APN
18315001
CURRENT_STATUS
02
SITE_LOCATION
15420 E HWY 4
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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GeoAnaiyticai Laboratories, Inc$ Lab Report#, <br /> Regulatory Yes Mo CC: Yes 13No <br /> 1445 Kansas Avenue Phone: (209)572-0900 Regulator: <br /> Modesto,CA 45351 Fax: (209)572-0916 <br /> Phone: &1) <br /> Client: 7 1 k CHAIN OF CUSTODY Fax: JUJ ) 1473 _I l 1 <br /> 44 <br /> Address: 6 0 EDF D EDT Original To: d <br /> City Zip 4) 13 FIELD LOGS C.0 To: <br /> Lab Use Only <br /> . Project ID jj- �/ � ,t� <br /> (Print Name) •�a°�e1811.4 <br /> ,�� ,bJ�' N I' <br /> Sampled B <br /> p Y Container u T <br /> (Signature) Confer <br /> Sample type z , <br /> Date Time Sample ID Tr pe Size Rana <br /> Grab Comp Matri <br /> -. - <br /> tx� 8 i <br /> Remarks r = ts <br /> C-� <br /> ALLRelinquished by(Signature) <br /> Dale Time R b (Si ature) 14M�te � Time <br /> D 2trw'; 123r <br /> Relinquished by(Signature) Date Time ivTime <br /> by(Signature) � <br /> P rvauve: <br /> 4 HCL Na.,8,0, -HNO, r 0-HPO,O-Oiher Drinking Water®Waste Water Hazardous Waste(Water)©$oill5olid <br /> Pump Truck Time 0 M110990 6 <br /> sailers 55 Gallon Drums <br /> .... �r!. Approved By: <br /> _.a (`1cn,....w,K�, I'1r.,r,i R�,.n I�iPI>ttinuen Rush (]D�her <br />
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